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THE 


Battle  Creek  Sanitarium 


History,    Organization, 
Methods 


BY 

J.   H.   KELLOGG,   M.   D.,  Superintendent 


[Incorporated  as  a  public  philanthropy  under  Act  No. 
242,  as  the  Michigan  Sanitarium  and  Benevolent 
Association.  Has  no  "branches,"  no  traveling  repre- 
sentatives, and  no  private  interest.] 


BATTLE  CREEK,   MICHIGAN 
1913 


"Nature  alone  can  cure;  this  is  the  highest 
laiv  of  practical  medicine,  and  the  one  to  which 
Tee  must  adhere.  .  .  .  Nature  creates  and 
maintains;    she  must  therefore  he  able  to  cure.'' 

—Died  (1845). 

''Diseases  are  not  entities  that  have  entered 
into  the  bod)^;  the^  are  not  parasites  that  take 
root  in  the  body;  they  merely  show  us  the  course 
of  the  vital  processes  under  altered  conditions.'' 

—Vircho-w  {1847). 


Copyright,  1 91 3 


FOREWORD 


HIS  little  brochure  is  presented  to  the  medical  public  in  re- 
sponse to  the  request  of  many  physicians  for  a  concise  epit- 
ome of  the  organized  curative  methods  which  in  recent  years 
have  come  to  be  collectively  known  as  the  Battle  Creek 
Sanitarium  System. 

After  consideration  it  has  seemed  proper  to  comply  with 
this  request  especially  because  of  the  surprise  and  interest  manifested  by 
hundreds  of  physicians  who  have  visited  the  institution  as  guests  and 
patients, —surprise  because  what  they  found  was  so  different  from  what 
they  had  expected  to  find,  and  interest  because  of  the  number  and  variety  of 
practical  applications  of  the  latest  resources  of  scientific  medicine  here 
systematically  employed. 

An  earnest  effort  has  been  made  to  present  a  picture  of  the  work  car- 
ried on  at  the  Battle  Creek  Sanitarium  as  nearly  as  possible  as  it  is  daily 
seen  in  actual  operation. 

The  existence  throughout  the  country  of  institutions  which  have  adopted 
the  name  "Sanitarium,"  although  really  nothing  more  than  medical 
boarding-houses,  has  given  to  the  medical  profession  as  well  as  to  the 
laity  many  Avrong  impressions  concerning  the  character  of  a  thoroughly 
scientific  and  up-to-date  sanitarium.  It  seems  but  just  that  the  profession, 
at  least,  should  know  that  there  "  is  a  dift'erence, ' '  that  the  name  Sanitarium, 
originating  here,  has  been  widely  exploited  and  in  numberless  instances 
most  unAvorthily  represented,  and  that  there  is  a  wide  contrast  between  a 
scientific  sanitarium  and  the  growing  multitude  of  institutions  which  imitate 
the  name  without  duplicating  the  thing  itself. 

The  generosity  of  the  original  founders  of  this  institution  in  devoting 
all  earnings  to  its  equipment,  operation,  and  betterment,  and  the  altruistic 
spirit  which  has  always  dominated  its  board  of  managers,  have  rendered 
possible  the  building  up  of  a  scientific  medical  enterprise  devoted  forever  to 
the  public  welfare  in  which  the  attempt  is  made — 

First. — To  put  into  active,  effective,  and  systematic  use  every  practical 
method  which  modern  medical  science  has  provided  for  the  accurate  de- 
termination of  deviations  from  the  normal  standard  of  health  in  structure 
or  function,  and  for  the  estimation  of  the  amount  of  such  variation,  so 
far  as  possible  expressing  these  variations  by  means  of  coefficients,  so  as 
to  make  exact  comparisons  possible. 

Second. — To  make  available  in  most  approved  form  every  rational 
curative  means  known  to  medical  science,  so  that  the  same  may  be  brought 
to  bear  in  any  individual  case,  giving  special  prominence  to  physical 
therapy,  or  so-called  physiologic  therapeutics. 

Third. To  combine  with  the  special  professional,  technical,  and  insti- 
tutional advantages  of  the  modern  hospital,  the  luxuries  and  comforts  of 
the  modern  hotel,  together  with  the  genial  atmosphere,  security  and  freedom 
■  of  the  home. 


'.    ^ 


THE    BATTLE    CHEEK    SANITARIUM 

Fourth. — To  organize  and  carry  fonvard  various  lines  of  research 
having  for  their  purpose  the  improvement  of  the  conditions  of  human 
life,  especially  in  relation  to  diet  and  nutrition, 

Fifth. — The  organization  and  maintenance  of  various  charities,  es- 
pecially hospitals  and  dispensaries  for  the  treatment  of  the  sick  poor. 

It  is,  of  course,  impossible  to  present  on  paper  anything  like  a  realistic 
picture  of  a  v^^ork  which  is  necessarily  so  extensive  in  volume  and  so  com- 
plex in  detail;  but  it  is  hoped  that  the  numerous  accompanying  photo- 
reproductions  may  aid  the  reader  in  forming  somewhat  of  a  definite  con- 
ception of  the  Battle  Creek  Sanitarium  System  as  it  is  seen  in  daily  practice. 


PREFACE   TO  SECOND   EDITION 

HE  favor  with  which  this  very  imperfect  presentation  of  the 
Battle  Creek  Sanitarium  Methods,  and  the  organization  which 
makes  possible  the  housing,  feeding,  and  treatment,  as  well 
as  education  and  training  of  a  thousand  sick  people  daily, 
not  by  routine  methods  but  with  minute  attention  to  the  needs 
and  indications  of  each  particular  case,  has  encouraged  the 
management  to  present  a  second  and  somewhat  improved  edition  which  it  is 
hoped  will  be  equally  acceptable  to  those  members  of  the  profession  who 
have  not  had  an  opportunity  to  personally  visit  Battle  Creek,  and  who  are 
interested  in  the  newer  therapeutics  which  finds  its  foundations  in  the 
results  of  laboratory  research  and  the  application  of  the  principle  an- 
nounced by  Dietl,  the  famous  German  pathologist,  "Nature  creates  and 
maintains,  therefore  she  must  be  able  to  cure." 

Every  physician  who  receives  this  brochure  is  cordially  invited  to  visit 
the  institution  and  to  personally  inspect  its  laboratories  and  various 
therapeutic  departments. 

Among  the  new  features  which  have  been  added  since  the  publication  of 
the  first  edition  may  be  especially  mentioned  notable  additions  to  the 
Roentgen  laboratory  which  have  given  it  recognition  as  belonging  in  the 
front  rank  of  the  world's  laboratories  of  this  sort. 

Among  other  important  additions  may  be  noted  the  Electro-cardiograph ; 
the  respiration  calorimeter  of  Benedict,  for  the  clinical  study  of  metabolism ; 
important  advances  in  the  bacteriological  laboratory  by  the  aid  of  Doctor 
Tissier,  of  the  Pasteur  Institute,  Paris,  consulting  bacteriologist  of  the  in- 
stitution ;  a  department  for  the  use  of  radium  in  all  the  various  ways  in 
which  recent  research  has  found  to  be  useful — viz.,  in  the  treatment  of 
inoperable  cancer,  and  certain  forms  of  gout  and  rheumatism. 

Improvements  are  constantly  being  made  in  all  departments,  both  in 
equipment  and  methods,  in  an  earnest  effort  to  keep  pace  with  the  foremost 
rank  of  progressive  scientific  medicine. 


CONTENTS 

PACK 

History  of  the  Battle  Creek  Sanitarium  :  Begun  1866  as  a  water- 
cure  in  a  small  two-story  wooden  building.  Reorganized  1876,  placed 
upon  a  rational  and  scientific  basis  under  regular  scientific  management.       ]  i 

■Organization:  Incorporated  1S67.  Reineori3orated  1S9S  under  the  pro- 
visions of  Act  No.  242  of  the  Public  Acts  of  18G:|.  entitled,  "An  Act 
for  the  incorporation  of  hospitals  or  asylums"   11 

Policy  and  Principles  of  the  Institution 11 

Buildings  :     First  main  building  dedicated  1878.     Main  buildings  destroyed 
by  fire,  1902.     New  fire-proof  building  dedicated  1903.     Present  build- 
ings  number  thirty   and   accommodate   one   thousand   patients,   besides 
several  hundred  nurses,  attendants,  and  other  emjjloyees 12, 14 

IReport  op  Committee  appointed  bj^  the  Business  Men's  Association  and 
Common  Council  of  the  City  of  Battle  Creek  to  investigate  the  organi- 
zation, status,  and  administration  of  the  institution,  especially  with  ref- 
erence to  its  philanthropic  character 25 

'Ti-iE  Battle  Creek  Sanitarium  System  :  A  composite  physiologic  method 
comprising  hydrotherapy,  phototherapy,  thermotherapy,  electrotherapy, 
mechanotherapy,  dietetics,  physical  culture,  open-air  cure  and  health 
training,  all  under  expert  direction  29 

Hydrotherapy  :  Comprising  more  than  200  hydriatic  procedures  with  ex- 
tensive hydriatic  treatment  room  and  equipment   61 

Phototherapy    and    Thermotherapy  :    The    electric-light    bath,    the    pho- 

tophore ;    the  thermophore,  the  arc-light  and  quartz  actinic  lamp    ....        71 

"Electrotherapy  :    Static   apparatus,   sinusoidal   apparatus,   high   frequency, 

X-i'ay,  galvanism,  f  aradie  and  various  special  electrical  appliances ....       73 

Diathermy 79 

Radium   81 

'Mechanotherapy:  Vibrating  tables,  chairs,  bars,  portable  vibrators,  me- 
chanical massage,  mechanical  percussion  and  friction,  mechanical  horse 
and  camel  93 

A.  System  of  Graduated  Strengthening  Processes  especially  adapted  to  in- 
valids and  sedentary  men  and  Avomen.  Light  gymnastics,  calisthenics, 
Swedish  gymnastics,  manual  movements,  apparatus  work,  outdoor  walks, 
swimming,  breathing  exercises,  under  direction  of  trained  medical  gym- 
nasts and  accurately  adapted  to  each  patient  by  means  of  the  universal 
dynamometer,  by  which  each  group  of  muscles  is  tested.  Outdoor  gym- 
nasium, survey  and  graduated  walks,  open-air  sleeping  arrangements.  . .       99 

9 


CONTENTS 

The  Battle  Creek  System  of  Diet^  consisting'  of  the  following: 

1.  Bill  of  fare  prepared  with  special  reference  to  the  needs  and  tastes  of 
invalids,  and  giving  the  value  in  calories,  or  food  units,  of  each  serving.     Ill 

2.  The  low  protein  ration  employed  here  for  forty  years,  and  recently 
demonstrated  by  Chittenden  and  Mendel  of  Yale,  and  by  other  inves- 
tigators to  be  most  conducive  to  health  and  endurance Ill 

3.  A  cuisine  embracing  hundreds  of  specially  prepared  foodstuffs  and 
tasty  dishes,  each  having  a  definite  and  detemiined  value 115 

4.  An  experimental  kitchen  and  food  laboratories  in  which  original  re- 
search is  constantly  bringing  out  new  facts  and  products 115 

5.  A  corps  of  specially  trained  cooks,  chefs,  and  dietitians 115 

6.  Farms  and  extensive  greenhouses  which  furnish  fresh  gTeen  vege- 
tables at  all  seasons   117 

Cases   Specially  Adapted  to   Treatment   by   the   Battle    Creek    Sani- 
tarium System    127 

The  Surgical  Ward  197 

The  Medical  Corps 197 

The  Obstetrical  Ward  199 

The  Kindergarten   201 

The  Sanitarium  and  Hospital  Training  School  for  Nurses 201 

The     Battle     Creek     Sanitarium     School     of     Health     and     Home 

Economics 201 

The  Battle  Creek  Sanitarium  Health  Foods 205 

Department  for  the  Treatment  of  Persons  with  Limited  Means  205 

No  Branches  and  no  Affiliated  Institutions   207 


10 


HISTORY 

ORTY  years  ago  a  little  band  of  men  who  believed  in  altruism 
and  human  progress  purchased  a  small  two-story  farmhouse 
in  a  fine  grove  in  the  edge  of  the  village  of  Battle  Creek, 
and  opened  a  "water-cure"  under  the  name  of  "The  Health 
Reform  Institute." 

Reorganization 

Ten  years  later  the  enterprise,  after  having  passed  through  various 
vicissitudes  and  having  failed  to  achieve  any  considerable  degree  of  suc- 
cess, was  placed  in  the  hands  of  the  present  management,  with  twelve 
patients  and  a  half  dozen  small  two-story  wooden  buildings. 

The  new  management  inaugurated  new  policies,  and  introduced  new 
methods  and  principles.  The  empirical  methods  of  the  oldtime  ' '  water-cure ' ' 
were  replaced  by  rational  hydrotherapy,  and  as  rapidly  as  possible  new 
methods,  appliances,  and  apparatus  were  added,  in  the  effort  to  create 
an  institution  which  would  show  in  practical  operation  all  the  resources  of 
rational  and  physiologic  medicine. 

The  management  of  the  new  institution  sought,  by  the  aid  of  the 
various  means  of  precision  afforded  by  scientific  medicine,  to  perfect,  and 
thus  place  upon  a  scientific  basis,  those  natural  curative  agencies  which, 
having  chiefly  originated  with  the  laity,  were  formerly  employed  almost 
exclusively  by  empirics. 

Those  physicians  who  came  in  contact  with  the  institution  soon  recog- 
nized the  new  order  of  things,  and  generally  gave  much  appreciated  en- 
couragement. At  that  time  there  existed  no  institution  which  combined 
the  comforts  of  the  home  and  the  hotel  with  the  medical  advantages  of  the 
hospital  and  the  added  facilities  and  equipment  requisite  for  the  adminis- 
tration of  baths  of  every  description,  electricity  in  its  different  forms, 
medical  gymnastics,  and  other  rational  agencies,  with  careful  regulation 
of  diet. 

Origin   of  the   Name 

The  new  management  and  new  policies  demanded  a  new  name.  The 
word  "sanatorium"  was  then  defined  by  Webster's  dictionary  as  a  term 
used  in  England  to  designate  a  health  resort  for  invalid  soldiers.  A 
change  of  two  letters  transformed  "sanatorium"  into  "sanitarium,"  and 
a  new  word  was  added  to  the  English  language. 

The  various  changes  effected,  including  rational  improvements  in  the 
equipment,  the  establishment  of  a  training  school  for  nurses,  and  the  or- 
ganization of  a  corps  of  scientifically  trained  physicians,  rapidly  won  the 
confidence  of  both  the  profession  and  the  public,  so  that  within  a  few 
months  one  hundred  patients  were  under  treatment;  and  the  management 
began  the  erection  of  a  building  especially  adapted  to  sanitarium  work, 
the  first  of  its  kind,  and  capable  of  accommodating  two  hundred  guests. 

11 


•THE    WATER    CURE" 1866 


THE  BATTLE  CREEK  SANITARIUM  — 1876 

12 


THE    BATTLE    CREEK    SANITARII'M 

Within  a  year  the  iieAv  i^tructure  was  dedicated  (1878),  and  for  twenty- 
four  years  thereafter  new  structures  were  added,  at  intervals  of  four  or 
five  years,  to  accommodate  the  growing  family,  which  in  the  summer  of 
1901  numbered  some  seven  hundred  guests. 

Fire    and    Reconstruction 

The  fire  of  February,  1902,  consumed  the  main  building  and  the  hos- 
pital. The  brick  and  wooden  structure  was  replaced  by  an  up-to-date 
and  absolutely  fireproof  building,  systematically  planned,  and  amply 
equipped  to  meet  the  increased  needs. 

The  gradual  growth  of  the  institution  is  shown  by  the  following 
figures : 

The  total  number  of  patients  dm-ing  the  first  year  was 106 

Ten  years  later,  the  total  number  of  patients  dui'ing  the  year (1876-7)   was     208 
After  another  ten-year  period,  the  total  number  of  patients   for  the  year 

(1886-7)  had  gTOwn  to   825 

During  the  year  1896-7  the  number  of  patients  was 1,584 

During  the  year  1906-7  the  number  was 2,800 

During  the  year  1911  the  number  was 5,307 

The  above  figures  represent  less  than  half  the  real  number  of  guests. 
The  actual  number  of  patients  during  the  year  1911  was  5,307. 

The  care  of  this  multitude  of  patients  requires  eight  hundred  to  a 
thousand  persons,  including  more  than  twenty  physicians  and  three  hundred 
nurses  and  bath  attendants.  Most  of  the  patrons  of  the  institution  are 
persons  who  are  suffering  from  chronic  disease,  especially  gastric  and 
nervous  disorders.  Insane  persons,  epileptics,  and  persons  suffering  from 
tuherculosis  or  other  communicahle  diseases  are  not  received.  The  guests 
always  include  a  considerable  number  of  persons  who  are  below  par 
physically  from  overwork  or  other  causes  and  visit  the  institution  for 
the  purpose  of  increasing  their  efficiency  by  general  health  culture  and 
training. 

The  Physiologic  Method 

The  Physiologic  Method,  sometimes  referred  to  as  "the  natural 
method,"  was  forty  years  ago  almost  entirely  in  the  hands  of  empirics. 
Through  the  application  of  the  scientific  method  to  the  various  hydriatic 
and  other  procedures  of  the  natural  method  they  have  been  rescued  from 
empiricism  and  have  been  organized  into  a  rational  system.  The  physio- 
logic method  consists  in  the  treatment  of  the  sick  by  natural,  physical, 
or  physiologic  means,  scientifically  applied. 

The  application  of  the  physiologic  method  requires  much  more  than 
simply  a  knowledge  of  the  technique  of  baths,  electricity,  movements,  etc. 
It  especially  requires  a  knowledge  of  physiology,  and  an  intelligent  grasp 
of  all  the  resources  of  modern  medical  science.  For,  while  the  physiologic 
method  depends  for  its  curative  effects  upon  those  natural  agencies  which 

13 


14 


THE    BATTLE    CREEK    SANITARIUM 

are  the  means  of  preserving  health,  and  which  may  be  r-(;lied  upon  to  pre- 
vent disease  as  well  as  to  cure  it,  it  recognizes  and  employs  as  collateral 
and  supplementary  remedies,  all  rational  means  which  have  by  experience 
been  proved  to  be  effective  as  adjuvants  or  palliatives. 

The   Physiologic   Method   Deals   with   Causes 

The  physiologic  method  concerns  itself  first  of  all  with  causes.  In  the 
case  of  chronic  maladies,  these  will  generally  be  found  in  erroneous  habits 
of  life,  which,  through  long  operation,  have  resulted  in  depreciation  of  the 
vital  forces  of  the  body  and  such  derangement  of  the  bodily  functions  that 
the  natural  defenses  have  been  finally  broken  down,  and  morbid  conditions 
have  been  established. 

Chronic  disease  is  like  a  fire  in  the  walls  of  a  house  which  has  slowly 
worked  its  way  from  the  foundation  upward,  until  the  flames  have  burst  out 
through  the  roof.  The  appearance  of  the  flame  is  the  first  outward  indi- 
cation of  the  mischief  which  has  been  going  on ;  but  it  is  not  the  beginning. 
It  is  rather  the  end  of  the  destructive  process. 

As  Hericourt,  the  learned  author  of  ''Les  Frontiers  de  la  Maladie," 
has  well  pointed  out,  the  man  who  is  recognized  to  be  suffering  from  chronic 
disease,  even  though  the  malady  may  be  said  to  be  in  an  incipient  state, 
has  really  been  ill  for  some  time,  as  the  existence  of  the  disease  is  evidence 
of  the  long-continued  insidious  operation  of  subtle  causes  which  have 
gradually  consumed  the  patient's  vital  capital,  wdped  out  his  margin  of 
safety,  and  established  definite  and  often  permanent  pathological  con- 
ditions. Disease,  then,  is  not  the  chief  ohject  of  attach  in  the  physiologic 
method,  hut  the  causes  of  disease. 

The  physiologic  method  does  not  undertake  to  cure  disease,  hut  patients. 
It  recognizes  the  disease  process  as  an  efiort  on  the  part  of  the  body  to 
recover  normal  conditions,— a  struggle  on  the  part  of  the  vital  forces  to 
maintain  life  under  abnormal  conditions  and  to  restore  vital  equilibrium. 

No  Routine,  No  Panaceas,  No  Fads,  No  Secret  Methods 

;  As  regards  the  methods  of  dealing  with  individual  ailments,  the  Battle 
Creek  Sanitarium  System  offers  no  panaceas  and  claims  no  secret  methods 
or  processes.  There  is  no  routine  or  "course  of  baths,"  no  violent  heroic 
measures,  no  empirical  formulas  for  any  disease  or  class  of  maladies.  The 
''system"  is  simply  a  rational  plan  of  leading  the  individual  out  of  suf- 
fering and  inefficiency  into  health,  comfort,  and  useful  activity.  Its  claims 
as  a  system  are  based  (1)  upon  a  working  plan  which  many  years  of 
experience  have  developed  for  the  ultilization  of  all  rational  curative  meas- 
ures, especially  those  of  a  physiologic  character,  combined  (2)  with  the 
complete  supervision  and  control  of  the  life  of  the  patient,  and  (3)  the 
application  of  methods  of  precision  in  the  study  of  vital  conditions,  normal 
and  pathological. 

At  the  outset  of  his  course  of  treatment,  the  patient  is  instructed  that 
his  recovery  will  depend  very  largely  upon  himself;  that  curative  power 
does  not  reside  in  the  doctor  nor  in  the  treatment,  but  in  the  vital  force 
operating  within  the  patient  himself. 

15 


WHAT   WAS   LEFT    FEBRUARY    18,    1902 


LAYING  THE  CORNER  STONE  OF  THE  NEW  BUILDING,   MAY   11,   3  902 

16 


THE    BATTLE    CREEK    SANITARIUM 

"It  is  the  Blood  That  Heals" 

Great  pains  are  taken  to  render  the  patient  intelligent  in  relation  to 
these  facts  and  principles.  He  is  taught  that  it  is  "  the  blood  that  heals ' ' ; 
that  most  chronic  disorders  are  the  result  of  deteriorative  changes  in  the 
blood ;  that  some  abnormal  content  or  some  deficiency  has  led  to  minute 
functional  or  structural  changes  which,  slowly  advancing  during  a  long 
period,  have  finally  resulted  in  so  great  a  disturbance  that  attention  is 
called  to  the  fact  by  symptoms,  so  that  he  discovers  that  he  is  ill;  that 
the  chronically  sick  person  is  in  a  state  of  low  vital  resistance,  and  hence 
that  his  treatment  necessarily  requires,  first  of  all,  the  exact  regulation  of 
all  his  habits,  and  the  establishment  of  natural  conditions  of  life.  The 
"simple  life"  and  "return  to  nature"  are  the  ideals  constantly  held  up 
before  him.  He  must  work  out  his  own  salvation;  he  must  "cease  to  do 
evil  and  learn  to  do  well;"  he  must  cease  to  sow  seeds  of  disease,  and  by 
every  means  in  his  power  cultivate  health. 


1-7 


DEDICATION   OF   THE  NEW   MAIN   BUILDING,    MAY  31,    1903 


NEW    MAIN    BUILDING 

18 


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ORGANIZATION  OF  THE  INSTITUTION 

HE  application  of  physiotherapy  in  a  scientific  and  efficient 
manner  requires  a  large  corps  of  nvirses  and  assistants  who 
are  trained  in  the  technique  of  hydrotherapy,  massage,  man- 
ual and  mechanical  Swedish  movements,  graduated  exercises, 
medical  gymnastics,  electricity  in  its  varied  forms,  thermo- 
therapy,  mechanotherapy,  phototherapy,  rational  dietetics, 
the  out-door  method,  and  various  other  physical  and  physiologic  agen- 
cies, in  addition  to  the  methods  of  ordinary  hospital  practice.  It  is  only  by 
this  concentrated  fire  from  a  well-trained  therapeutic  battery  that  those 
Gribraltars  of  disease  commonly  called  incurable  maladies  can  be  made  to 
capitulate. 

Trained  Assistants 

To  conduct  a  sanitarium-hospital  on  a  thoroughly  physiologic  and  sci- 
entific plan  requires  a  corps  of  workers,  or  "health  trainers,"  averaging 
for  the  whole  year  one  to  one  and  a  half  persons  per  patient  treated. 
Without  the  greatest  vigilance,  the  number  will  increase  even  to  three  or 
more  for  every  patient.  For  example,  at  the  Battle  Creek  Sanitarium  the 
number  of  persons  employed  is  never  less  than  eight  hundred,  and  often 
rises  in  the  busiest  season  to  more  than  one  thousand.  In  the  summer 
season  the  number  of  patients  and  employees  is  about  equal.  In  the  winter 
season  the  number  of  patients  is  often  only  half  that  of  the  employees. 
Large  numbers  of  attendants  must  be  in  training  in  preparation  for  the 
busy  months. 

To  do  all  that  can  be  done  for  a  chronically  sick  person  to  assist  him  to 
recovery,  to  surround  such  a  person  with  every  possible  advantage  known 
to  modern  medical  science,  requires  an  expenditure  for  facilities,  attendants, 
and  running  expenses  far  beyond  any  possible  income  except  under  one  con- 
dition, viz.,  that  many  of  those  engaged  in  the  work  shall  be  willing  to 
make  a  partial  contribution  of  their  services,  receiving  at  most  merely 
nominal  wages,  barely  sufficient  to  meet  the  actual  cost  of  living  on  a  very 
simple  basis.  Physicians,  managers,  nurses — everybody  concerned  in  the 
enterprise,  must  be  interested  in  it  from  a  scientific  and  philanthropic 
standpoint,  and  willing  to  consider  as  chief  compensation  the  satisfaction  of 
seeing  men  and  women  restored  to  health,  who,  without  the  services  ren- 
dered, would  have  little  prospect  but  the  grave. 

The   Main   Buildings 

These  consist  of  four  large  buildings,  chief  of  which  is  the  concrete, 
structure  dedicated  May  31,  1903.  This  building,  which  affords  rooming 
accommodations  for  about  400  guests,  contains  also  offices  for  the  physicians, 
treatment  rooms  capable  of  handling  more  than  1,000  patients,  dining- 
room  accommodations  for  an  equal  number,  a  gymnasium  120  by  66  feet. 
The  bath  buildings  are  three-story  and  basement,  and  with  the  gymnasium 

19 


ROOF    GARDEN,    MAIN     BUILDING 


DISPENSARY    AND    OFFICE    BUILDING 

20 


THE    BATTLE    CREEK    SANITARIUM 

are  joined  to  the  main  building  by  a  semicircular  corridor.  Within  the 
semicircle  is  a  great  Palm  Garden,  which  connects  the  gymnasium  with  the 
lobby  of  the  main  building,  as  shown  in  the  accompanying  ground  floor 
plan. 

The  construction  is  brick,  iron,  stone,  and  Portland  cement.  There  are 
no  wood  floors  nor  partitions.  The  floors  are  solid  slabs  of  artificial  stone, 
reinforced  by  strong  iron  cables.  The  partitions  are  of  mackolite.  The 
floors  are  surfaced  with  Italian  terrazza  mosaic. 

The  building  being  frost-proof  as  well  as  fire-proof,  it  is  easy  to  main- 
tain a  uniform  artificial  climate  in  the  cold  months,  with  a  day  temperature 
of  70  degrees  F.  and  a  night  temperature  of  60  degrees  F. 


SKCTCrt  PLAN   "'*  mj5T  -PlooiS 
BATH-C  OZECK   SANITAKIUfA 
LCN6TM  "Main  building  S60 
WI&Trt  50^.     -^-^  E-ACH    ei 
DOTANCe  BtTWCtN    FROi 
LOBO'*'    •■*»'BeAia    "^  GYMNASiUj 


GROUND     FLOOR    PLAN 


A  most  efiicient  ventilating  system  supplies  more  than  one  hundred  and 
fifty  thousand  cubic  feet  of  warm  fresh  air  per  minute.  The  fresh  air  is 
admitted  warm  to  the  corridors,  and  distributed  by  means  of  individual 
ducts,  connecting  each  room  directly  with  the  open  air.  The  ventilation 
system  is  automatic  and  always  works.  The  ducts  are  of  sufficient  capacity 
to  give  each  patient's  room  an  ample  supply  of  air  for  five  or  six  persons. 
The  air  of  the  building  is  always  and  everywhere  fresh  and  pure,  and  free 
from  odor  of  every  sort.  This  is  chiefly  due  to  the  location  of  the  kitchen 
and  dining-room  at  the  top  of  the  building.  The  heavy  masonry  construc- 
tion of  the  building  with  the  stone  floors  render  it  cool  in  summer  as  well  as 
warm  in  winter.  There  being  no  wood  floors  and  no  carpets,  there  is 
freedom  from  dust  (rugs  are  used  and  vacuum  cleaning).  The  wide  cor- 
ridors and  simple  style  of  structure  secure  free  movement  of  air.  There  are 
pleasant  parlors  and  ample  foyers  on  every  floor.  There  are  also  porches 
and  balconies  on  each  floor  and  a  large  roof  garden  which  is  partly  covered 
and  used  for  outdoor  sleeping. 


21 


22 


THE    BATTLE    CREEK    SANITARIUM 

The  building  has  been  erected  and  equipped  at  a  cost  of  $800,000.00, 
and  no  pains  or  expense  has  been  spared  to  make  it  in  every  way  thoroughly 
fit  for  the  purpose  for  which  it  is  used. 

A  Tropical  Corner 

The  large  palm  garden  (40  x  60  ft.)  is  separated  from  the  great  central 
lobby  by  a  glass  partition,  and  its  fresh,  genial  atmosphere  and  delightful 
tropical  plant  life  make  it  a  favorite  place  of  resort.  A  corridor  leads 
through  the  center  of  the  palm  garden  from  the  main  lobby  to  the  great 
gymnasium. 

The  sight  of  bunches  of  bananas  ripening  on  huge  stems  towering  twenty 
feet  in  height  suggests  the  tropical  delights  of  Florida  in  the  midst  of 
the  splendid  health-winning,  pure  winter  air  of  Michigan. 

Patients  are  fond  of  gathering  under  the  wide-spreading  palms  to  chat 
over  their  lunches  served  on  trays  while  enjoying  the  tropical  scene  and 
the  pure  fragrant  air. 

Recognized   as  a   Philanthropy 

The  institution  is  incorporated  under  a  statute  of  the  State  of  Michigan 
which  provides  for  the  organization  of  hospitals  and  other  charitable  insti- 
tutions and  exempts  them  from  taxation. 

Shortly  after  the  great  fire  which  destroyed  the  main  buildings  of  the 
institution  the  Battle  Creek  Business  Men's  Association  and  Board  of  City 
Aldermen,  by  request  of  the  Sanitarium  Management,  appointed  a  com- 
mittee consisting  of  three  of  the  leading  business  men,  a  leading  clergyman, 
and  the  president  of  the  City  Bank,  to  look  into  the  affairs  of  the  institu- 
tion. The  two  pages  which  follow  present  the  essential  portion  of  the  com- 
mittee's summary  of  their  findings  respecting  the  object,  character,  work, 
and  administration  of  the  institution: 


23 


THE    LOBBY 


THE    MAIN    PARLOR 
24 


THE    BATTLE    CREEK    SANITARIUM 

REPORT  OF  THE  CITIZENS'  COMMITTEE 

"Summing  up  the  results  of  our  investigations,  we  have  to  report  as 
follows: 

"1.  The  fSanitarium  is  organized  under  the  provisions  of  Act  No.  242 
of  the  Public  Acts  of  the  State  of  Michigan  as  a  philanthrophic  and  char- 
itable institution. 

"The  Articles  of  Association  of  the  Battle  Creek  Sanitarium,  so  far 
as  they  relate  to  the  questions  involved  in  our  investigation,  provide  as 
follows : 

"  'The  object  of  said  corporation  and  other  matters  germane  and  aux- 
iliary thereto,  are  as  follows : 

The   Charitable   and   Philanthropic    Objects   of   the   Organization 

"  'To  found  a  liospital  or  charitahle  asylum  within  the  State  of  Michigan 
for  the  care  and  relief  of  indigent  or  other  sick  or  infirm  persons,  at  which 
institution  may  he  received  also  patients  and  patrons  who  are  able  to  and  do 
pay  for  the  benefits  there  received,  and  ivhicli  institution  shall  devote  the 
funds  properly  acquired  and  received  by  it  from  time  to  time  from  all 
sources,  exclusively  to  maintaining  itself,  improving  its  condition  and  fa- 
cilities and  promoting  its  purposes,  by  such  sanitary,  dietetic,  hygienic, 
and  philanthropic  reforms  and  efforts  as  are  germane  or  auxiliary  thereto; 
all  of  its  said  purposes  being  undenominational,  unsectarian,  philanthropic, 
humanitanan,  charitable,  and  benevolent,  and  in  no  manner  directly  or 
indirectly  for  private  profit  or  dividend  paying  to  any  one.' 

"3.  It  is  therefore  clear: 

"a.  That  no  profits  of  the  institution  can  ever  accrue  or  be  lawfully 
paid  to  any  private  party  or  parties  whatsoever, 

"b.  That  no  funds  of  the  institution  can  be  lawfully  sent  outside  the 
State  to  build  or  support  other  enterprises  of  any  kind. 

"c.  That  any  and  all  revenues  of  the  institution  must  be  devoted  to 
philanthropic  and  charitable  work  within  the  State  of  Michigan,  and  to 
developing  and  extending  the  facilities  of  the  institution  itself,  and  for 
these  purposes  only. 

"d.  That  all  of  the  property  of  the  institution  is  held  in  trust  for  the 
above  philanthropic  and  charitable  purposes  only. 

"e.  That  title  to  any  of  the  property  of  the  institution  can  never  be 
passed  to  any  private  party  or  parties  whatsoever,  but  can  only  be  trans- 
ferred at  the  expiration  of  the  statutory  limit  of  the  corporation  to  the 
trustees  of  another  corporation  organized  for  the  same  purpose  and  under 
similar  restrictions.  ... 

"The  revelations  made  by  our  investigation  have  been  a  surprise  to 
us.  Not  only  were  we  personally  unaware  of  the  wholly  philanthropic 
nature  of  the  institution,  under  the  law,  but  we  were  also  unaware  of  the 
vast  amount  of  charitable  work  performed  by  it,  and  the  wonderful  sac- 
rifices made  by  the  managers  and  employees  generally. 

"The  large  corps  of  physicians  receive  no  professional  fees,  and  only 
weekly  wages  so  small  that  their  services  are  practically  a  charity.  This 
is  also  true  of  the  hundreds  of  nurses  and  helpers.     They  are  a  band  of 


THE   PALM    GARDEN 

26 


THE    BATTLE    CREEK    SANITARIUM 

sincere  people,   conscientiously  devoting  themselves  to   a  great  work  for 
humanity,  and  not  for  personal  gain.  .  .  . 

"The  more  deeply  we  have  gone  into  the  investigation,  the  more  con- 
vincing and  overwhelming  the  proofs  have  become  of  the  straightforward 
management,  the  lofty  purpose,  the  widespread  beneficence  of  the  insti- 
tution, and  above  all,  of  the  personal  devotion  and  wonderful  self-sacri- 
fice of  the  nearly  one  thousand  persons  employed  in  it. 
'  'Eespectf ully  submitted, 

"S.  0.  BUSH, 
"I.  L.  STONE, 
"GEO.  E.  HOWES, 
"W.  S.  POTTER, 
"NELSON  ELDRED, 

"Committee." 

The  above  findings  of  the  committee  concerning  the  philanthropic  char- 
acter of  the  institution  were  confirmed  by  the  decision  in  favor  of  the 
institution  in  the  tax  suit  brought  for  the  purpose  of  determining  the  status 
of  the  institution  in  its  claim  to  exemption  from  taxes  because  of  no  private 
interest  in  its  earnings. 


27 


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28 


THE  BATTLE  CREEK  SANITARIUM  SYSTEM 

HE  application  of  the  physiologic  method  requires  for  its 
foundation  more  than  an  answer  to  the  question,  What  disease 
has  this  patient?  Is  it  rheumatism,  dyspepsia,  locomotor 
ataxia,  neurasthenia,  etc.  ?  It  demands  a  minute  inquiry  into 
the  exact  vital  status  of  the  individual ;  a  determination  of  the 
degree  of  activity  and  efficiency  of  each  of  the  great  bodily 
functions.  It  requires  a  complete  inventory  of  the  patient's  vital  assets. 
To  accomplish  this,  the  patient  must  be  tested  and  calipered  by  every 
means  known  to  science,  and  the  results  must  be  reduced  to  the  most  ex- 
act mode  of  expression,  to  coefficients  and  ''graphics"  when  possible,  for 
convenience  of  comprehension  and  comparison. 

These  examinations  must  be  made,  not  once,  but  many  times,  being  re- 
peated at  frequent  intervals,  so  that  the  effect  of  the  treatment  may  be 
recognized,  and  any  necessary  modifications  may  be  made. 

Receiving  the  Patient 

The  patient,  on  his  arrival  at  the  Sanitarium,  after  having  selected  his 
room,  visits  the  medical  office,  where  his  name  and  address  are  taken  by  the 
receiving  physician,  and  a  few  general  facts  respecting  his  case  ascertained, 
sufficient  to  make  clear  the  general  character  of  his  case ;  that  is,  whether  it 
be  surgical  or  medical,  and  if  medical,  whether  the  services  of  a  specialist 
will  be  required,  and  if  so,  which  department  is  indicated.  The  patient 
is  then  assigned  to  the  particular  one  of  the  thirty  physicians  employed  in 
the  institution  who  is  especially  qualified  by  training  and  experience  to  best 
deal  with  his  particular  case,  and  there  is  placed  in  his  hand  a  blank  pre- 
scription booklet  which  bears  his  name  and  number,  together  with  the  name 
of  the  physician  to  whom  he  is  assigned.  In  this  booklet  will  be  recorded  the 
various  prescriptions  for  hydrotherapy,  phototherapy,  mechanical  and 
manual  movements,  walking,  swimming,  and  other  exercises,  hours  for 
rest,  suggestions  concerning  diet,  including  the  quantities  expressed  in 
calories  of  proteins,  carbohydrates  and  fats,  and  general  suggestions.  The 
book  also  contains  blanks  for  the  records  of  the  daily  meals,  of  strength  and 
weight  tests,  and  a  blank  program  on  which  the  physician  will  indicate  the 
hours  for  the  various  treatments,  exercises,  and  measures  to  which  the  pa- 
tient is  to  be  subjected  during  each  day. 

The  Examination 

The  physician  designated  takes  the  patient  in  hand,  and  listens  to  his 
own  account  of  his  ailments.  Assistance  is  often  rendered  by  the  letter 
of  introduction  which  the  patient  often  brings  from  his  home  physician. 
In  this  examination  the  aim  is  not  simply  to  discover  symptoms  but  to 
learn  the  exact  state  of  the  fundamental  vital  processes, — what  is  the  con- 
dition of  the  patient's  metabolism?  Does  metabolic  insufficiency  exist? 
Is  an  abnormal  degree  of  tissue  destruction  taking  place?  To  what  degree 
is  the  functional  efficiency  of  any  vital  organ  or  set  of  organs  diminished, 

29 


INSTRUMENTS   EMPLOYED    IN    DIAGNOSIS 

30 


THE    BATTLE    CREEK    SANITARIUM 

especially  as  regards  muscle,  heart,  lungs,  stomach,  blood,  liver,  kidneys? 
All  known  means  are  brought  to  bear  to  discover  any  possible  organic 
changes  in  the  brain  or  nerves,  heart,  liver,  kidneys,  arteries  or  other 
vital  parts.  Special  emphasis  is  laid  upon  certain  points  M^hich  are  of  par- 
ticular interest  in  the  application  of  hydriatic  and  other  physiologic 
methods. 

The  patient  removes  his  clothing,  or  so  much  of  it  as  is  necessary,  and 
is  subjected  to  a  minute  physical  examination. 

Then  examination  of  the  viscera  is  made  so  far  as  they  are  accessible  by 
physical  means,  inspection,  palpation,  auscultation,  percussion,  etc. 

In  cases  which  indicate  the  necessity  therefor,  an  internal  examination 
is  made. 

The  patient  is  referred  to  experts  in  various  departments,  as  the  in- 
dications may  suggest. 

The  X-ray,  through  stereo-radiography  and  fluoroscopy  with  the  bismuth 
meal,  renders  valuable  service.  The  electro-cardiograph,  the  sphygmograph, 
and  other  graphic  methods  are  employed,  together  with  the  respiration 
calorimeter  and  all  known  efficiency  tests. 

Examination  of  the  Skin 

In  making  the  physical  examination,  first  attention  is  given  to  the  skin, 
note  being  taken  not  only  of  the  color  of  the  skin,  as  indicative  of  anemia, 
chlorosis,  Addison's  disease,  jaundice,  metallic  poisoning,  certain  drug 
effects,  etc.,  and  of  the  presence  or  absence  of  common  skin  maladies,  but 
also  of  its  texture  and  appearance, — whether  it  is  dry  or  moist,  etc. 
The  effects  of  mechanical  and  thermic  stimuli  are  studied.  Special  note 
is  taken  of  the  indications  of  intestinal  autointoxication,  concerning  which 
the  skin  rarely  fails  to  give  accurate  and  reliable  information.  In  the  em- 
ployment of  hydrotherapy,  the  study  of  the  skin  is  particularly  important, 
for  the  reason  that  a  bloodless,  hide-bound  skin,  dry  and  rough  to  the  touch, 
not  only  indicates  a  deficient  peripheral  circulation,  but  is  also  necessarily 
associated  with  an  excessive  accumulation  of  blood  in  the  viscera.  An 
anemic  skin  generally  means  a  congested  liver,  and  the  same  condition  of 
other  viscera.  Hydriatic  and  other  physiologic  methods  are  the  only  means 
by  which  this  condition  of  the  skin  can  be  permanently  improved,  hence  the 
only  means  by  which  viscera  congestion  can  be  definitely  removed. 

Examination  of  the  Mouth  and  the  Tongue 

Careful  inspection  of  the  mouth  affords  information  not  only  in  re- 
lation to  the  teeth,  but  of  the  body  in  general,  for  decay  of  the  teeth  or 
disease  of  the  gums  is  very  frequently  a  local  indication  of  general  vital 
deterioration;  and  an  infected  state  of  the  mouth  may  be  an  efficient  and 
continuing  cause  of  intestinal  or  gastro-intestinal  autointoxication.  The 
condition  of  the  tongue  and  the  breath  is  an  important  indication  in  re- 
lation to  intestinal  autointoxication,  a  condition  of  primary  importance  in 
the  etiology  and  the  therapeutics  of  chronic  diseases. 

Bacterial  cultures  are  made  in  cases  in  which  there  is  reason  to  suspect 

31 


INSTRUMENTS    EMPLOYED   IN    DIAGNOSIS 

32 


THE    BATTLE    CREEK    SANITARIUM 

infection  of  the  mouth  with  pathogenic  bacteria.  The  throat,  nose,  tonsils. 
and  pharynx  are  inspected  especially  with  reference  to  local  infection 
and  a  possible  relation  to  intestinal  autointoxication  or  other  systemic 
disease. 

Testing  the   Lungs  and   the   Heart   . 

The  lungs  are  examined  by  the  ordinary  means,  including  determina- 
tion of  the  lung  capacity.  In  addition,  determination  is  made,  by  means 
of  the  universal  dynamometer,  of  the  strength  of  the  diaphragm  and  of  the 
muscles  of  the  chest.  Imperfect  aeration  of  the  blood  is  not  infrequently 
the  result  of  weakness  and  lack  of  tone  of  the  respiratory  muscles,  although 
the  actual  lung  capacity  may  be  ample.  Many  feeble  invalids  live' in  a  sta'te 
of  half  asphyxiation,  notwithstanding  a  splendid  lung  capacity,  because  of 
deficient  respiratory  activity.  Respiratory  strength  and  respiratory  weight 
coefficients  are  obtained,  which  show  at  once  the  degree  to  which  the  respir- 
atory function  is  deficient. 

In  addition  to  a  stethoscopic  examination  and  a  careful  noting  of  all 
the  indications  of  cardiac  or  circulatory  disturbances,  a  determination 
is  made  of  the  blood-pressure,  both  systolic  and  diastolic. 

X-Ray  Examination  of  the  Heart 

The  marvelous  advances  made  in  X-ray  technique  within  the  last  five 
years  have  rendered  this  examination  the  most  important  and  reliable  means 
of  determining  the  size  and  position  of  the  heart  and  large  vessels.  By  a 
very  powerful  apparatus  which  has  recently  been  perfected,  it  is  possible 
to  obtain  a  radiograph  of  the  heart  in  a  small  fraction  of  a  second  so 
sharp  and  accurate  outlines  of  the  heart  are  obtained.  It  is  now  also  possi- 
ble to  apply  the  Roentgen  cinematograph  to  the  study  of  the  movements  of 
the  heart.  The  views  of  the  heart  and  chest,  as  shown  herewith,  are  fair 
illustrations  of  the  valuable  aid  given  by  the  Roentgen  laboratory  of  the  in- 
stitution in  the  study  of  diseases  of  the  heart  and  blood-vessels. 

The   Electro-Cardiograph 

The  discovery  that  contractions  of  the  heart  are  accompanied  by  the 
production  of  electrical  currents  which  can  be  measured,  made  ]yy  Waller 
more  than  twenty  years  ago,  has  finally  led  to  the  perfection  of  apparatus 
by  means  of  which  information  can  be  obtained  respecting  the  morbid  con- 
ditions of  the  heart,  both  organic  and  functional,  which  cannot  be  obtained 
in  any  other  way.  This  new  method,  which  is  of  the  greatest  value  in  the 
study  of  diseases  of  the  heart,  is  as  yet  very  little  known  on  this  side  of  the 
Atlantic.  The  management  congratulate  themselves  in  being  among  the 
first  to  introduce  into  this  country  this  important  means  of  diagnosis.  *  The 
accompanying  plate  shows  the  forms  of  cardiograms  obtained  in  different 
conditions  of  the  heart  and  blood-vessels  (Nicolai). 

Study  of  the  Blood-Pressure 

The  arteries  are  examined  for  evidence  of  degenerative  change,  note 
being  taken  of  the  condition  of  both  the  arteries  and  the  veins,     s'phyg- 

33 


BLOOD  EXAMINATIONS 

34 


THE    BATTLE    CREEK    SANITARIUM 


mographic  tracings  are  made  of  the  pulse,  and  cardiograph  tracings  are 
made  when  there  is  any  indication  therefor.  The  growing  prevalence  of 
arteriosclerosis,  and  the  recognition  of  the  important  part  which  this  dis- 
order plays  in  a  large  number  of  chronic  maladies,  give  to  this  feature  of 
the  examination  an  importance  which  has  come  to  be  fully  appreciated 
only  in  recent  times. 

This  research  is  especially  important  in  the  employment  of  the  physio- 
logic method  for  the  reason  that  this  method  is  the  most  efficient  remedy 
for  disorders  of  blood-pressure.  These  conditions  are  purely  symptomatic, 
and  can  be  relieved  only  by  dealing  with  their  causes.  It  is  now  generally 
recognized  that  drugs  which  raise  or  lower  blood-pressure  are  only  pal- 
liative in  their  effects,  and,  on  the  whole,  do  more  harm  than  good.  Most 
drugs  which  diminish  high  blood-pressure  ultimately  produce  secondary 
low  pressure,  a  still  worse  condition. 

The  resources  of  hydrotherapy  render  most  valuable  service  both  in 
high-pressure  and  low-pressure  cases.  In  their  application  these  measures 
must  be  most  carefully  gauged  by  the  findings  of  the  sphygmomanometer. 

In  making  blood-pressure  determinations,  both  the  systolic  and  dias- 
tolic readings  are  recorded. 

These  examinations  are  made  by  an  expert  daily  at  the  Physiologic 
Laboratory  at  12  m.  to  1  p.  m.  Patients  are  examined  in  their  rooms  when 
unable  to  visit  the  office. 

The  large  number  of  blood-pressure  determinations  which  have  been 
made,  numbering  to  date  (July,  1912)  over  30,000,  has  demonstrated 
some  very  important  practical  facts  in  relation  to  the  advantages  of  the 
physiologic  method.  A  second  examination  nearly  always  indicates  a 
marked  fall  within  two  or  three  weeks  in  high-pressure  cases;  while  an 
equally  favorable  rise  occurs  in  cases  in  which  the  blood-pressure  is  ab- 
normally low.  This  fact,  it  is  believed,  demonstrates  in  a  large  way  the 
advantages  of  the  antitoxic  diet  and  toxin-free  regimen. 

When  the  blood-pressure  has  been  brought  down  from  200  mm.  to  150 
mm.,  or  less,  the  usual  result  in  cases  not  too  far  advanced,  by  the  correction 
of  the  patient's  habits  of  life,  and  the  application  of  physiologic  measures, 
and  without  the  use  of  drugs  of  any  sort,  there  is  good  ground  for  expecta- 
tion that  by  carefully  following  a  prescribed  regimen  the  patient  may 
retain  the  benefits  which  have  been  received,  and  thus  his  span  of  useful 
life  may  be  considerably  lengthened. 

Examination  of  the  Blood 

This  includes  not  only  the  determination  of  the  hemoglobin  by  means 
of  Dare's  instruments,  but  a  determination  of  the  blood-count,— that  is, 
the  number  of  blood-cells  per  cubic  millimeter. 

In  cases  of  anemia,  suspected  malarial  infection,  and  all  cases  in  which 
other  special  indications  are  present,  a  differential  count  of  the  blood  is 
made.  In  cases  in  which  gouty  conditions  are  suspected,  Garrod's  test  for 
uric  acid  in  the  blood  is  made. 

A  bacteriological  examination  of  the  blood  is  made  in  cases  in  which 
such  an  examination  is  likely  to  aid  in  diagnosis,  as  in  suspected  malignant 
endocarditis  and  other  blood  infections. 

35 


Dr. E..,K-...H. 

No.'^lX22>. 

BATTLE  CREEK  SANITARIUM  CLINICAL  LABORATORY 

REPORT  ON  BLOOD  EXAMINATION 

CaseofMV.^j,.'^^.^.' State.. %<m^. 


PER    CENT- 


Hemoglobin.     Dare  64 

Red  cells.     N„.3  ,500  ,000    per  cu.  ,.„,.     (Normal  ]  ^,™  ;„  5,-J^)  77. 

White  Cells.     No 1.6,800   per  cu.  mm.     (Normal  7,500)  2.25. 

One  to  208     red  (Normal  i  to  666)  Color  Index  or  Coefficient  8..3.. 

Specific  Gravity  (Hammerschlag)  ...1049 

Blood  Pressure.     Systolic      125    Diastolic  JLlO 

Pulse  96 

DIFFERENTIAL  COUNT  OF 600  LEUCOCYTES 


NORMAL  ELEMENTS 


PER  CKNT  OF 
NUMBER       I         ENTIRE 
COLINTED      I    LEUCOCYTE 
j  COUNT 


.3,60 1 .60 

...M 1 15 


Small  Lymphocytes 
Large  Lymphocytes 

Large  Mononuclear  Leucocytes  i 

Transitional  Forms  -  -  -- 

Polymorphonuclear  Neutrophiles  4t^.U <d,0.« 

Eosinophiles  -  -  -  13  2« 


PATHOLOGIC.A.L   ELEMENTS 


Myelocytes 


(3-fi) 


(1-2) 


Normoblasts 


Intermediate. 


(!--') 


Megaloblasts  . 


Microcytef 


(2-4) 


Mast  Cells 


Macrocytes ... 

j      (.r.) 
JL.» 1 Poikilocytes 


Avcraj^e  measurement  of  red  cells X.l/..2mikrons.     (Normal  7^  mikrons.) 

Morphology. 

Parasites  and  other  pathological  elements    HOllO    present 

This  test  to  be  repeated  in 

Remarks : 

A... ..¥►.. .11* .Analyst 

'■Date. S/26 .1^1 12  -^M. 

EXAMINATIONS    OF    THE    BLOOD 


36 


TPIE    BATTLE    CREEK    SANITARIUM 

Blood  determinations  are  made  at  the  same  hour  daily,  so  that  the  find- 
ings may  be  properly  comparable.  In  cases  in  which  there  is  marked  devia- 
tion from  the  normal  standard,  frequent  re-examinations  are  made. 

Gastric    Examinations 

In  the  office  examination  the  physician  makes  note  of  the  position  of 
the  stomach,  which  is  determined  by  percussion,  palpation,  inflation,  the 
X-ray,  and  other  means. 

Various  tests  for  determining  the  gastric  motility  are  made  use  of. 

"When  there  is  an  indication  therefor,  a  test  meal  is  administered:  first, 
the  test  breakfast  of  Ewald;  later,  if  necessary,  a  test  dinner  or  a  test  sup- 
per, the  test  meal  of  Boas,  or  other  special  meals  as  may  be  indicated.  If 
the  patient  vomits,  an  examination  is  made  of  the  vomited  matters. 

The  nature  of  the  test  meals  and  the  method  of  administration  are 
those  ordinarily  employed,  hence  need  not  be  described.*  A  difference 
exists,  however,  in  one  important  particular:  the  test  meal,  of  whatever  sort, 
is  made  thoroughly  aseptic  before  it  is  administered.  Care  is  taken  also  to 
make  the  tube  thoroughly  sterile.  Ordinary  bread  is  not  used,  as  it  eon- 
tains  immense  numbers  of  bacteria,  and  often  yeasts  and  molds.  Plain 
water  bread,  specially  prepared  in  the  form  of  zwieback,  so  as  to  be  per- 
fectly sterile  and  wholly  free  from  bacteria,  lactic  acid,  or  other  foreign 
substances,  is  invariably  used. 

The  chemical  technic  employed  is  essentially  that  of  Hayem  and  AA^'inter, 
of  Paris,  very  elaborate  and  tedious,  but  of  all  methods  the  most  exact. 
This  quantitative  method  gives  information  which  can  be  obtained  by  no 
other,  and  when  supplemented  by  some  of  the  methods  of  Toepfer,  Mett, 
and  Marley,  wdth  some  devised  in  our  own  laboratory,  leaves  nothing  over- 
looked that  can  be  determined  by  chemical  tests. 

A  thoroughly  practical  and  efficient  method  of  estimating  the  products 
of  carbohydrate  digestion  in  the  stomach  was  worked  out  in  our  laboratories 
many  years  ago  (1895),  and  has  been  in  use  since,  having  been  applied  in 
more  than  25,000  cases.  This  estimation  of  sugar  and  other  soluble  carbo- 
hydrates is  the  only  means  of  determining  the  degree  of  activity  and  ef- 
ficiency of  salivary  digestion. 

Gastric  examination  is  the  bacteriological  study  which  was  begun  more 
than  twenty  years  ago  and  has  been  found  to  be  of  great  service  in  dealing 
with  many  forms  of  gastric  disease,  particularly  chronic  gastritis  and 
achylia.  These  examinations  are  repeated  until  the  stomach  is  found  to  be 
free  from  bacteria. 

Flouroscopic  and  Cinematographic  Examinations  of  the  Stomach 

By  fluoroscopic  examination  of  the  stomach  and  intestine  after  a  bismuth 
meal  complete  information  may  be  obtained  respecting  the  motility  of 
these  organs.  The  accuracy  of  the  findings  made  by  these  methods  has 
been  tested  in  many  hundreds  of  cases  in  which  subsequent  operation  was 
performed.     These  new  methods  of  examination  have  thrown  great  light 

*Methods  of  Precision  in  the  Investigation  of  Disorders  of  Digestion.  Read 
before  the  Mississippi  Valley  Medical  Association,  Oct.  13,  1892.  Modem  Med- 
icine Publishing  Co.,  Battle  Creek,  Mich. 

37 


38 


THE    BATTLE    CREEK    SANITARIUM 

upon  the  physiology  as  well  as  the  pathology  of  the  stomach.  By  their  use 
in  connection  with  stereoscopic  radiographs  it  is  possible  to  locate  with 
almost  unerring  certainty  ulcers,  neoplasms  adhesions  and  other  morbid 
conditions  which  were  formerly  in  many  cases  beyond  the  reach  of  the  best 
diagnostic  skill. 

The  accompanying  illustration  will  give  something  of  an  idea  of  the 
invaluable  service  rendered  by  the  radiographic  department  in  the  study  of 
diseases  of  the  stomach  and  intestines.  Highly  useful  information  may  be 
obtained  by  radiographic  and  fluoroscopic  examinations  of  the  stomach  in  all 
cases  of  chronic  disease  of  this  organ. 

Bacteriological   Examinations   of   Gastric   Fluids 

The  systematic  bacteriological  examination  of  gastric  fluids  was  be- 
gun in  the  laboratory  of  hygiene  of  the  Battle  Creek  Sanitarium  in  the 
summer  of  1895,  and  has  been  continuously  carried  forward  since.  The 
technique  developed  at  that  time  is  still  followed  in  its  essential  details. 
Then  it  was  generally  believed  that  bacteria  were  constantly  present  in 
the  stomach  in  considerable  numbers ;  but  by  employing  a  sterile  test  meal, 
it  was  discovered  that  bacteria  are  only  exceptionally  present  in  the  stom- 
ach, and  that  their  presence  is  an  indication  of  the  absence  of  an  efficient 
gastric  juice.  In  achylia  great  numbers  of  bacteria  are  always  found 
present,  ordinarily  two  or  three  million  per  c.c.  of  gastric  fluid,  but  oc- 
casionally twenty  millions  or  more.  This  determination  is  of  the  highest 
importance  as  an  indicator  for  the  application  of  gastric  antisepsis  and 
a  test  of  the  efficiency  of  the  methods  used. 

The  accompanying  photo-reproductions  of  gastric  reports  (see  page 
42)  show  the  findings  in  the  case  of  an  extreme  hyper-hydrochloria  and  in 
a  case  of  achylia. 

Examination    of    the    Feces 

Examination  of  the  alimentary  residue  is  scarcely  secondary  in  im- 
portance to  examination  of  the  gastric  contents  after  a  test  meal. 

Examination  of  the  fecal  residue  gives  us  definite  information  respect- 
ing the  changes  which  the  food  has  actually  undergone  while  passing 
through  the  entire  length  of  the  alimentary  canal.  The  presence  of  un- 
digested foodstuffs,  of  unabsorbed  fats,  proteins,  or  carbohydrates,  of  bac- 
teria swarming  in  numbers  vastly  greater  than  the  normal,  are  important 
facts  which  have,  until  recently,  been  almost  wholly  left  out  of  consider- 
ation. The  examination  of  the  feces  for  tapeworm  and  other  parasites, 
though  essential,  is  of  small  importance  when  compared  with  the  determ- 
ination of  undigested  or  unused  foodstuffs,  and  the  presence  of  parasitic 
bacteria  in  numbers  fifty  to  a  thousand  times  greater  than  the  normal. 

An  examination  of  the  feces  is  made  in  every  case.  The  details  of  this 
examination  may  be  readily  seen  by  reference  to  the  accompanying  illustra- 
tion (page  44),  which  is  a  copy  of  a  report  made  in  a  recent  case.  Special 
emphasis  is  laid  upon  the  bacteriological  study  of  the  feces  as  being  of 
far  greater  importance  in  a  great  majority  of  cases  than  the  microscopical 
and  chemical  study,  although  chemical  and  microscopical  examinations 
are  not  neglected  and  in  a  few  cases  are  given  essential  information. 

:{9 


GASTRIC   LABORATORY 

40 


THE    BATTLE    CREEK    SANITARIUM 

By  means  of  the  bacteriological  examination  an  exact  determination  of 
the  condition  of  the  flora  is  made.  The  character  of  the  flora  determines 
the  dietary  and  to  a  considerable  degree  also  the  treatment  of  the  patient. 
By  repeated  examinations  it  is  possible  to  show  what  progress  is  being 
made  in  getting  rid  of  undesirable  flora  and  reinstating  the  normal  pro- 
tective flora.  This  department  is  not  only  thoroughly  equipped  with  all 
necessary  appliances,  but  employs  a  number  of  skilled  and.  experienced 
bacteriologists,  and  in  addition  has  the  benefit  of  the  great  skill  and  ex- 
perience of  two  consulting  bacteriologists  who  are  well  recognized  as 
authorities  in  the  bacteriology  of  the  intestinal  tract — Professor  Tissier, 
of  the  Pasteur  Institute,  Paris,  and  Dr.  Distaso  of  the  Royal  Institute  of 
Public  Health,  London. 

Thorough  examination  of  the  feces  is  made  in  every  case  on  arrival, 
and  in  cases  requiring  it  the  examinations  are  repeated  at  intervals  during 
the  course  of  treatment. 

The  antitoxic  character  of  the  bill-of-fare  discourages  the  growth  of 
putrefactive  and  other  pathogenic  bacteria  in  the  intestine,  as  do  also  the 
various  means  adopted  for  increasing  peristaltic  activity  and  so  relieving 
stasis.  In  all  cases  of  intestinal  autointoxication  the  patient  is  encouraged 
to  acquire  the  habit  of  moving  the  bowels  at  least  three  times  daily,  or 
after  each  meal.  This  is  not  accomplished  through  the  use  of  irritating 
drugs,  but  by  regulation  of  the  diet  and  by  restoration  of  the  normal  flora, 
which,  as  has  been  shown  by  Tissier,  is  alone  sufficient  in  the  majority  of 
cases  to  secure  normal  bowel  action. 

Professor  Tissier  has  shown  that  the  normal  protective  flora  of  the  in- 
testine consists  almost  exclusively  of  Bacillus  hifidus  and  other  acetogen- 
ous  microbic  species.  To  facilitate  the  change  of  flora  which  is  found  to 
be  absolutely  necesary  for  a  complete  cure  in  most  cases  of  chronic  disease, 
large  use  is  made  of  cultures  of  protective  micro-organisms,  especially 
cultures  of  the  Bacillus  hifidus  obtained  from  Professor  Tissier  of  the 
Pasteur  Institute  and  the  Bacillus  Bulgaricus  of  Grigoroff.  The  accom- 
panying plate  illustrates  the  practical  value  of  this  method  of  reinstating 
the  normal  protective  flora  of  the  intestine. 

Radiographic    Examination    of    the    Colon 

The  X-ray  department  renders  invaluable  service  in  the  examination 
of  cases  of  chronic  constipation  and  in  cases  in  which  there  is  suspicion  of 
cancer  or  other  morbid  growths  in  the  intestine.  By  means  of  stereoscopic 
radiography  of  the  colon,  which  was  perfected  in  the  Roentgen  laboratory  of 
this  institution,  it  is  possible  to  locate  the  exact  seat  of  stasis  in  the  in- 
testine. The  extreme  value  of  the  information  obtained  by  means  of  radio- 
graphic examinations  of  the  colon  is  clearly  sho\\Ti  by  the  following  illus- 
trations, which  are  reproduced  from  plates  selected  from  hundreds  of 
similar  plates  on  file  in  our  Roentgen  laboratory. 

By  fluoroscopic  examination  of  the  colon  while  introducing  bismuth 
solution,  the  location  of  obstructions  from  contractions  or  kinks  may  be 
exactly  determined,  together  with  the  degree  of  existing  obstruction.  The 
information  obtained  by  this  means  is  of  the  greatest  service,  not  only  in 

41 


42 


THE    BATTLE    CREEK    SANITARIUM 

rendering  possible  an  exact  diagnosis,  but  also  in  suggesting  means  of 
treatment. 

In  the  application  of  massage  to  the  colon  the  radiograph  serves  as  a 
most  valuable  guide. 

Tests  For  Renal  Efficiency 

The  condition  of  the  kidneys  is  a  matter  of  primary  importance  in 
the  great  majority  of  cases  of  chronic  disease.  The  ordinary  examination  of 
the  urine  really  gives  very  little  information  concerning  either  the  con- 
dition of  the  kidneys  or  of  the  metabolic  processes  of  the  body.  When 
disease  of  the  kidneys  is  so  far  advanced  that  albumin  and  casts  are  found 
present  in  the  urine,  it  is  generally  too  late  to  accomplish  anything  more 
for  the  patient  than  to  arrest  the  disease  and  by  careful  treatment  and 
regimen  prolong  his  life  and  usefulness.  A  complete  cure  is  of  course  im- 
possible. A  thoroughly  reliable  means  of  determining  the  actual  efficiency 
of  the  kidneys  in  the  removal  of  toxins  from  the  body  has  been  long  sought, 
but  until  recently  no  really  accurate  method  was  available.  We  are  now 
in  possession,  however,  of  a  method  by  which  the  efficiency  of  the  kidneys 
may  be  very  accurately  tested.  This  method,  discovered  by  Drs.  Geraghty 
and  Rountree,  of  Johns-Hopkins  Hospital,  we  have  tested  in  a  large  number 
of  cases  and  have  found  of  the  very  greatest  service  in  determining  the 
condition  of  the  kidneys  and  thus  aiding  in  settling  important  questions  re- 
lating to  prognosis,  fitness  for  operation,  etc. 

Another  important  test  for  renal  efficiency  is  the  "water  test."  The 
patient  is  given  a  liter  of  water  in  the  morning  before  taking  food  or  liquid 
and  the  amount  eliminated  in  the  following  five  hours  indicates  the  power 
of  the  kidneys  to  eliminate  water,  which  is  perhaps  its  most  important 
function.  Eighty  per  cent  of  the  water  taken  should  be  recovered  in  the 
time  named. 

The    Urinary    Examination 

As  ordinarily  made,  urinary  examinations  give  comparatively  little 
information.  The  solid  substances  found  in  the  urine  have  two  sources  of 
origin;  first,  the  foodstuffs;  second,  the  tissues.  No  examination  of  the 
urine  can  be  considered  as  exact  and  resting  upon  a  scientific  basis  which 
does  not  take  account  of  the  ingested  substances,  as  well  as  of  those  re- 
sulting from  tissue  metabolism. 

The  first  urinary  examination  is  made  at  once  on  the  patient's  arrival. 
A  searching  examination  of  the  urine  is  made  by  the  most  exact  methods 
known  to  physiologic  chemistry. 

The  function  of  the  pancreas  is  tested  by  the  Cammidge  reaction  of 
the  urine  and  by  application  of  the  method  of  Gros  to  the  feces.  The 
efficiency  of  the  liver  is  also  determined  by  suitable  tests. 

The  Wasserman  test  for  syphilis  is  made  and  the  opsonic  index  de- 
termined in  cases  in  which  these  tests  are  indicated. 

The    Bacteriological    Laboratory 

The  bacteriological  laboratory  was  equipped  and  put  into  operation 
years  ago  (1895),  after  two  visits  to  the  Pasteur  Laboratory  of  Paris  and 

43 


Examination  of  Feces 

Xo 14473,.. Bnir Sept....2.7,  /ry;^, 

3/ H.  A. JI. ^,. M. 


PHYSICAL 


Amount  moist gms I?.?. 

Amoimt    dry ...s-ms _...l  :.f...... 

Color    ' 1 ^^^^ 


Odor 

Putrid 

Form 

Mushy 

Food  remnants 

Ilorraal 

Mucus 

Mixed 

Parasites     

0 

CHE,MICAL 

0 


Beaetion J   ^'1'*  Acid  c.  c. 

1  N/10  Alk.  c.  c °^. 

Biuret ^.T^.9.. 

-,,  /Proteolytic .9. , 

Enzymes     |  ^„^^,^j^.^.^. 0 

Bile  reduction  .0. 

Occult    Blood Q 

Blood Q 

BACTERIOLOGICAL 

Dominant  Bacteria Mary  B.J7elchii,   many  B.Coli, 

Protetis  Vulgaris. 


Character  of  Flora. 


Bad 


MICROSCOPICAL 

Vegetable  cells D.. 

Starch   granides.... .9.. 

Fat  globules 9-. 

Fatty  acid  crystals ..:.. 


Soap  crystals ...f.QJP. 

Yellow  ealciimi  salts few 

Amnion io-Magnesinm  phosphate  ciyst Q 

Other    crystals ....phosphates 

Pus Q 

Blood .0 

Epithelia    Q 

Parasites ..-. ....9. 

Parasitic  Ova ....^ ..9. 


^■^^■^^-^^ C:,..N,..R, Analyst. 


4:4: 


THE  BATTLE  CREEK  SANITARIUM 

other  European  laboratories,  and  was  placed  in  charge  of  an  expert  who 
had  been  trained  under  Pasteur,  in  the  Pasteur  Institute. 

This  department,  in  charge  of  trained  bacteriologists,  also  has  the  ad- 
vantage of  advice  and  counsel  of  two  of  the  most  eminent  living  bacteriol- 
ogists, who  have  been  for  many  years  connected  with  the  Pasteur  Insti- 
tute of  Paris,  namely.  Professor  Tissier  of  the  Pasteur  Institute,  and 
Doctor  Distaso,  formerly  first  assistant  to  Professor  Metchnikoff,  of  the 
Pasteur  Institute  and  now  bacteriologist  of  the  Royal  Institute  of  Public 
Health  of  London,  and  consulting  bacteriologist  to  leading  London  hos- 
pitals. Research  work  is  constantly  in  progress  in  this  department,  in  which 
great  assistance  is  derived,  as  well  as  in  the  settlement  of  individual 
problems  which  are  constantly  arising,  from  the  advice  and  counsel  of 
the  eminent  experts  above  mentioned. 

Bacteriological  examinations  of  all  sorts  and  the  preparation  of  vaccines 
for  the  purpose  of  combating  various  forms  of  bacterial  infection  by  im- 
munization are  supplied  by  this  department  to  meet  the  needs  of  special 
oases. 

In  addition  to  the  ordinary  sputum  and  similar  examinations  which 
are  made  in  this  department,  special  researches  are  made  for  the  purpose 
of  determining  the  presence  or  absence  of  bacteria  in  the  blood  and  other 
tissues,  and  original  studies  are  constantly  in  progress. 

A  large  amount  of  work  is  done  for  the  general  public  and  the  profes- 
sion of  Battle  Creek  and  vicinity,  as  the  Sanitarium  Clinical  Laboratory  is 
also  the  official  laboratory  for  the  municipality  of  Battle  Creek.  Hundreds 
of  examinations  of  milk,  drinking  water,  and  food  supplies  of  various  sorts 
are  annually  made  for  the  Health  Department  of  the  city,  in  addition  to 
special  examinations  of  specimens  relating  to  typhoid  fever,  pneumonia, 
diphtheria,  and  other  maladies.  The  report  of  this  department  for  the 
year  ending  Dec.  31,  1911,  showed  the  following  work  done: — 

Report  of  Clinical  Laboratories  for  the  Year   1911 

Bacteriological  examinations  for  diphtheria    295 

Bacteriological  examinations  of  sputum   --....  378 

Bacteriological  examinations  of  gastric  fluid   136 

Bacteriological  examinations  of  feces   •■ 2,598 

Bacteriological  examinations  of  urine   48 

Bacteriological  examinations  of  blood 14 

Determinations  of  opsonic  index - 5 

Examinations  of  blood  for  malarial  plasmodia   82 

Examinations  of  blood  for  trypanasomes    2 

Examinations  of  blood  for  Widal  reaction    - , 86 

Examinations  of  blood  for  Wasserman  reaction    96 

Examinations  for  diplococcus  of  Neisser 86 

Bacteriological  examinations  of  pus   50 

Bacteriological  examinations  unclassified  ....-- 48 

Examinations  of  blood  for  blood-count  and  hemoglobin 6,223 

Differential  counts  of  white  blood  corpuscles 327 

45 


LABORATORY    FOR    FECAL 

46 


THE    BATTLE    CREEK    SANITARIUM 

Quantitative  examinations  of  urine   -- 7,303 

Complete  quantitative  examinations  of  urine  with  determination  of  uric  acid, 

phosphates,  sulphates,  ammonia,  and  total  nitrogen   69 

Chemical  examinations  of  gastric  fluids ....  1,367 

Chemical  and  microscopical  examinations  of  feces   2,597 

Fecal  examinations,  experimental  researcli   85 

Chemical  examinations  of  foods   - 147 

Examinations  of  foods,  experimental  research   66 

Chemical  and  bacteriological  examinations  of  milk   192 

Chemical  and  bacteriological  examinations  of  water    46 

Microscopic  examinations  of  tissues  from  operations  and  autopsies    309 

Total     - 22,655 

The    Graphic    Method 

For  many  years  special  attention  has  been  given  to  the  graphic  method 
in  the  representation  of  the  results  obtained  by  laboratory  and  clinical 
research  in  individual  cases.  One  of  the  more  recent  and  most  practical 
applications  of  the  method  is  to  the  study  and  management  of  cases  of 
disturbed  metabolism.  While  this  method  is  applied  to  numerous  forms  of 
metabolic  disturbance,  it  renders  most  essential  service  in  the  treatment 
of  cases  of  diabetes,  obesity,  and  the  various  cachexias.  The  accompanying 
graph  shows  the  progress  of  the  diabetic  patient  under  treatment. 

In  making  this  graphic  study  of  metabolism,  note  is  taken  of  the  fol- 
lowing data,  which  is  determined  with  great  care  by  experts  in  the  several 
methods  of  examination  required: — 

1.  The  amount  of  food  sugar  (calculated  as  glucose). 

2.  The  amount  of  urinary  sugar. 

3.  The  coefficient  of  sugar  utilization. 

4.  The  food  and  urinary  nitrogen. 

5.  The  nitrogen  balance  and  from  it  the  tissue  loss  or  gain. 

6.  The  amount  of  acidosis  (acetone  and  diacetic  acid). 

'The  study  of  metabolism  has  been  recently  much  facilitated  by  the  in- 
stallation of  the  new  respiration  calorimeter  devised  by  Doctor  Benedict  of 
the  Carnegie  Nutrition  Laboratory  at  Boston.  Through  the  courtesy  of 
Doctor  Benedict  the  expert  in  charge  of  this  department  was  permitted  to 
spend  some  weeks  in  the  practical  use  of  this  ingenious  and  delicate  appa- 
ratus in  the  Boston  laboratory,  under  instruction  by  Doctor  Benedict,  and 
thus  we  are  enabled  to  make  the  first  application  of  this  new  method  to  the 
study  and  treatment  of  clinical  cases.  This  apparatus  is  shown  in  the  ac- 
companying cut. 

By  means  of  the  respiration  calorimeter,  it  is  now  possible  to  study  with 
accuracy  the  metabolism  of  starch  and  other  carbohydrates,  a  matter  of 
much  interest  not  only  in  cases  of  diabetes,  but  also  in  cases  of  obesity, 
emaciation,  and  various  cachexias. 

47 


LABORATORY    FOR    URINARY    EXAMINATION 
48 


PHYSICAL 

Per  cent 
of  Av'a^e 

Average 
Men 

Average 
Women 

Collected    during    (hrs.) 

24 

24 

Quantity  .    .    .    .    (c.  C.) 

1200 

1100 

Color 

Amber 

Amber 

Deposit 

0 

0 

Odor 

Urinous 

Urinous 

Specific  Gravity 

1013 

1012 

Total  Solids  .    .    .    (gm) 

34.19 

27.46 

Freezing  Point  ^ 

—1.31° 

—1.15° 

Urinary  Depuration 

4.175 

4.200 

Water  Elimination 

80% 

80% 

Renal  Efficiency  (Phthalein  Test) 

CHEMICAL 

Ac.  Terms  H^  PO^  (gm) 

1.00 

.79 

Total   Nitrogen    .    (gm) 

7.43 

5.40 

Urea      ....       (gm) 

13.29 

9.88 

Uric  Acid    .    .    .     (gm) 



.332 

.308 

Ammonia    .     .     .     (gm) 

.300 

.295 

Creatinin    .     .     .     (gm) 

.96 

.63 

Chlorides    .     .     .     (gm) 

6.89 

6.93 

Phosphates      .     .     (gm) 

1.75 

1.17 

Fixed  Sulphates  .   (gmSOg) 

1.113 

.776 

Ethereal  Sulphates  (gmSOg) 

.132 

.106 

Neutral  Sulphur  .   (gmS03) 

.186 

.200 

Sugar    ....     (gm) 

0 

0 

Diacetic  Acid 

0 

0 

Acetone 

0 

0 

Albumin   .    .    (%  Vol.) 

0 

0 

Bile 

0 

0 

Indican 

0 

0 

Indolacetic  Acid 

0 

0 

Urobilin 

0 

0 

MICROSCOPICAL 

Organic 
Casts    .'    .    (No.   in  field) 

Chemical 
Urates 
Uric  Acid  Crystals 

Pus  Cells  .    (No.  in  field) 

Calc.  Oxal.  Crystals 

Blood  Cells    (No.  in  field) 

Spermatozoa  (No.  in  field) 
Epithelia             Mucus 
Bacteria              Yeast  Cells 

Phosphates 

Triple  Phos.  Crystals 

Other  Crystals 

URINARY    EXAMINATION    BLANK 
49 


THE     DYNAMOMETER 

50 


THE    BATTLE    CREEK    SANITARIUM 

Anthropometric  Examinations 

In  the  office  examination  a  careful  note  is  taken  of  the  condition  of 
the  patient's  muscles,  his  general  state  as  regards  weight,  etc.,  but  the 
examination  does  not  stop  at  this  point.  By  means  of  a  specially  con- 
structed dynamometer,  the  strength  of  each  one  of  the  larger  groups  of 
muscles  is  tested.  The  patient's  weight  is  carefully  determined,  and 
various  coefficients  are  worked  out. 

The  physiologic  method  recognizes  in  deteriorated  muscular  strength 
both  a  cause  and  a  consequence  of  various  abnormal  states,  and  hence  under- 
takes to  remedy  this  condition  by  means  of  various  forms  of  exercise — 
passive,  active,  and  active-passive. 

The  intelligent  application  of  this  means  requires  first  of  all  a  careful 
measurement  of  the  patient's  muscular  capacity.  The  strength  of  the 
lungs  can  not  be  determined  by  testing  the  arms ;  neither  can  the  strength 
of  the  abdominal  muscles  be  measured  by  determining  the  strength  of  the 
grip.  The  strength  of  each  of  the  thirty  great  muscular  groups  of  the 
body  must  be  determined  and  charted  in  order  to  get  an  exact  picture 
of  the  sum  total  of  the  patient's  muscular  ability. 

An  attempt  to  accomplish  this,  after  some  years  of  experiment,  re- 
sulted in  the  construction  of  the  Universal  Dynamometer,  which  is  in  use 
in  many  gymnasiums,  including  those  of  the  leading  universities  of  this 
country,  and  has  been  for  years  in  use  by  the  United  States  government 
in  its  military  and  naval  schools. 

The  comparative  study  of  the  measurements  obtained  from  several 
hundred  persons  rendered  possible  the  preparation  of  a  table  of  strength 
coefficients  of  considerable  scientific  interest.* 

The  Strength  Graphic 

The  accompanying  photo-reproduction  of  the  graphic  blank  (see  page 
53)  shows  how  the  results  of  the  dynamometer  examination  are  made  visible 
to  the  eye.  Anthropometric  measurements,  such  as  are  employed  in 
scientific  gymnasia,  are  also  made  in  each  individual  case. 

Examinations  of  32,098  cases  (Dec.  31,  1911),  have  been  made  in 
this  department.  The  standard  figures  were  of  course  worked  out  from 
data  of  healthy  persons.  The  compilation  of  this  data  has  made  possible  the 
preparation  of  a  table  showing  the  strength  of  various  groups  of  muscles 
as  compared  Avith  those  of  homologous  muscles,  or  muscles  of  the  opposite 
side  in  the  same  individual,  and  in  average  individuals  of  the  two  sexes. 

For  ready  comparison  with  the  normal  standard  the  results  are  plotted 
upon  the  graphic  blank,  which  is  shown  in  reduced  form.  By  means  of 
this  graphic  record  it  is  possible  to  determine  at  a  glance  the  relation  of 
the  strength  of  any  group  of  muscles  to  the  normal  for  an  individual  of 


*"A  New  Dynamometer  for  Use  in  Anthropometiy,"  "Phvsieal  Coefficients." 
Modern  Medicine,  1895.     Battle  Creek,  Mich. 

"The  Vah;e  of  Strength  Tests  in  the  Prescription  of  Exercise."  Modern  Med- 
icine, 1896.     Battle  Creek,  Mich. 


51 


TESTING    THE    MUSCLES 

52 


HIMUT     In 


g|  ^  rf 


NEUROLCGICAL    EXAMINATION 

51 


THE    BATTLE    CREEK    SANITARIUM 

given  height  and  sex,  as  well  as  the  total  for  the  legs,  arms,  or  any  other 
given  part,  or  for  the  body  as  a  whole. 

Under  training,  the  gain  in  strength,  as  shown  by  the  dynamometer, 
is^ often  very  rapid,  a  gain  of  500  pounds  in  a  week  being  not  uncommon. 

The   Study  of  the   Physique 

In  the  anthropometric  examination,  special  note  is  made  of  the  physique 
and  the  figure,  the  condition  of  such  important  groups  of  muscles  as  thos^ 
of  the  back  and  abdomen,  and  the  respiratory  muscles.  When  necessary, 
outlines  are  taken  of  the  body  by  means  of  a  special  device  for  the  purpose, 
by  which  deviations  from  the  normal  type  are  graphically  shown. 

The  correction  of  these  deficiencies  and  deformities  is  essential  to  a 
permanent  cure  in  many  forms  of  chronic  disease.  A  flat  chest  and  a  bulg- 
ing abdomen  are  most  always  associated  with  intestinal  catarrh,  constipation, 
indigestion,  gallstones,  colon  disease,  appendicitis,  pelvic  disease,  congested 
liver,  movable  kidneys,  or  some  other  pathological  condition  which  is  in 
part  at  least  the  result  of  muscular  weakness  or  deficient  development  and 
can  be  permanently  cured  only  by  strengthening  the  weak  muscles  by 
proper  exercises. 

Neurological    and    Physiological    Examinations 

A  careful  phj^siological  and  neurological  examination  is  essential  in 
many  cases.  Such  examinations  may  afford  valuable  information  in  a 
very  large  number  of  the  chronic  cases  which  come  under  observation  in  an 
institution  like  the  Sanitarium.  For  example,  neurasthenics  are  often 
greatly  disturbed  by  paresthesias  and  other  symptoms  which  do  not  indi- 
cate organic  change  of  any  sort,  and  which  quickly  disappear  under  appro- 
priate treatment. 

A  great  point  is  gained  in  being  able  to  assure  such  persons  by  careful 
neurological  and  psychological  tests  that  their  brains  and  nerves  are  sound 
organically,  and  that  the  clamoring  sensations  which  they  experience  are 
only  the  reflected  complaints  of  disordered  viscera,  or  the  outgrowth  of 
disturbed  metabolism. 

Modern  neurological  and  psychological  researches  have  developed  a 
number  of  new  methods  by  which  the  structural  and  functional  conditions 
of  the  central  nervous  system  may  be  tested.  By  subjecting  the  patient  to 
the  proper  tests,  it  is  possible  to  determine  with  accuracy  the  actual  con- 
dition of  the  principal  cerebral  and  spinal  centers,  and  the  extent  of  devia- 
tipn  f rom  the  normal  standard  may  thus  be  recognized  and  recorded. 

In  these  examinations  the  chronometer,  kymograph,  and  various  other 
delicate  calipering  and  measuring  devices  of  the  psychologic  laboratory  are 
appealed  to,  and  often  with  the  most  interesting  results,  showing  the 
variations  in  the  rate  of  nerve  transmission,  or  of  the  recognition  of  im- 
pressions of  various  sorts,  the  time  required  for  judgment  or  decision, 
the  reaction  time  with  various  forms  of  stimuli,  etc. 

These  tests  are  exceedingly  valuable  to  the  physician  employing  the 
physiologic  method,  in  enabling  him  to  know  the  ability  of  the  patient 
to  respond  to  the  various  powerful  therapeutic  agencies  which  are  at  com- 
mand for  utilization  in  his  case.     Hydriatic  agents  are  like  artillery;  they 

55 


5G 


THE    BATTLE    CREEK    SANITARIUM 

are  big  guns,  capable  of  accomplishing  great  good  if  ])j'operly  aimed, 
bait  may  be  equally  effective  for  mischief  when  used  without  intelligent 
direction. 

Convenient  graphic  blanks  representing  various  regions  of  the  body 
are  utilized  in  recording  the  pathological  conditions  which  can  be  graph- 
ically represented. 

The   Photographic   Department 

An  extensive  photographic  department  is  maintained,  experienced 
photographers  being  constantly  employed.  The  business  of  this  department 
is  to  make  photographs  of  pathological  conditions  when  required,  as  an  aid 
to  the  medical  record,  and  to  makke  slides,  photographic  enlargements,  and 
other  paraphernalia  for  use  in  the  school  of  health  and  other  educational 
departments  of  the  institution.  The  photographs  with  which  this  book  is 
illustrated  are  the  product  of  this  department. 

This  department  is  fitted  out  with  apparatus  for  making  moving  pict- 
ures and  photographs  in  natural  colors.  It  renders  invaluable  service  also 
in  reproducing  the  radiographs  of  the  Roentgen  Ray  department  for  pur- 
poses of  record  and  to  send  to  physicians  by  whom  are  sent  patients  for 
examination. 

Special  Examinations 

Thoroughgoing  examinations  of  the  bladder  by  means  of  the  cystoscope 
are  made  in  cases  in  which  there  are  indications  of  bladder  disease.  Ex- 
aminations are  also  made  of  the  ureter  and  the  kidneys  in  cases  of  suspected 
disease  of  these  organs. 

Bectoscopy  is  largely  employed  as  an  aid  in  dealing  with  diseased  con- 
ditions of  the  rectum  and  lower  colon. 

The  bronchoscope  is  employed  when  necessary  for  the  examination  of 
the  trachea  and  bronchi,  and  for  the  removal  of  foreign  bodies  which  find 
entrance  to  these  parts. 

The  newly  perfected  gastroscope  of  Eisner  is  found  useful  as  a  means 
of  diagnosis,  but  also  permits  the  making  of  applications  to  the  gastric 
mucous  membrane. 

The  esophagoscope  permits  the  removal  of  foreign  bodies  from  all  parts 
of  the  esophagus  and  also  from  the  interior  of  the  stomach. 

Wasserman  reaction,  Pirquet,  and  other  tests  for  tuberculosis  and  all 
other  known  special  tests  are  employed  as  indicated  in  individual  cases. 


57 


DENTAL    DEPAflTMENT 


THE    DENTAL    NURSE 


MEN  'S    RECEIVING    OFFICE 
58 


THE  KECORD  VAULT 


STEREOPTICON  SLIDE  RACK 

59 


60 


THE  BATTLE  CREEK  SANITARIUM  SYSTEM 
OF  HYDROTHERAPY 

HIS  system  of  using  water  therapeutically  has  been  worked 
out  at  the  Battle  Creek  Sanitarium  during  nearly  forty  years 
of  scientific  work. 

The  crude  but  thoroughgoing  methods  of  the  original  sys- 
tem of  Priessnitz,  which  succeeded  among  the  hardy  mountain- 
eers of  Austrian  Silesia,  were  much  too  strenuous  for  more  deli- 
cately organized  and  pampered  American  invalids.  This  fact,  together  with 
the  gross  empiricism  which  characterized  the  use  of  water  in  the  first  half 
of  the  last  century,  when  water-cures  were  for  a  time  almost  a  fad,  brought 
water  into  general  disrepute  as  a  curative  means,  and  greatly  hindered  the 
scientific  development  of  this  invaluable  agent. 

Organized    Hydrotherapy 

The  older  system  lacked  greatly  in  adaptability,  because  of  the  want 
of  means  of  accurate  adjustment  to  different  grades  of  vitality  and  various 
peculiarities  of  temperament.  Many  new  methods  have  been  devised  to  fill 
in  the  gaps,  and  have  made  possible  a  perfectly  graduated  course  of  hy- 
driatic  procedures  by  which  the  tonic  effects  of  cold  water  are  made  avail- 
able to  the  feeblest  patient  as  well  as  the  strongest. 

The  Battle  Creek  Sanitarium  system  of  hydrotherapy  gives  due  promi- 
nence to  hot  as  well  as  to  cold  applications.  As  first  introduced  into  this 
country,  hydrotherapy  was  essentially  a  ' '  cold  water  cure, "  as  it  was  pop- 
ularly called,  and  thousands  were  more  or  less  damaged  by  the  routine 
and  drastic  procedures  of  those  days,  while  many  other  thousands  failed 
to  derive  from  hydriatic  measures  the  benefits  which  they  might  have  re- 
ceived under  scientific  management,  and  as  a  natural  result  the  whole 
system  fell  into  disrepute,  and  water  as  a  curative  agent  acquired  a  bad 
reputation,  which  in  uninformed  quarters  still  clings  to  it. 

The  Battle  Creek  Sanitarium  System  for  the  first  time  correlated  with 
the  use  of  water  in  all  possible  forms  the  use  of  electricity,  medical  gym- 
nastics, massage,  dietetics,  phototherapy,  and  all  other  physiologic  measures 
of  cure,  by  this  means  greatly  increasing  its  efficiency,  and  constituting  a 
practical  and  organized  system  of  physiologic  therapeutics  in  one  place 
and  under  one  management. 

Here  was  first  developed  an  organized  and  systematized  assemblage  of  all 
known  curative  agents,  especially  those  of  a  physical  nature,  in  actual 
practical  operation.  Elsewhere  most  of  the  same  agents  may  be  found  in  use 
singly,  and  hence  less  effectively,  and,  as  a  result,  in  many  cases,  unsuc- 
cessfully. Here  all  work  together  in  therapeutic  concert,  and  are  thus 
able  to  achieve  success  in  cases  in  which  less  systematic  and  thorough- 
going therapeutic  attempts  have  failed. 

61 


62 


THE    BATTLE    CREEK    SANITARIUM 

Mydriatic   Equipment 

Two  complete  buildings  are  devoted  to  this  department,— one  i'()i-  luen. 
the  other  for  women.  They  are  both  connected  with  the  main  Ijuildiny 
and  with  the  large  gymnasium  by  a  great  semi-circular  corridor,  the  gym- 
nasium standing  between.  Each  of  the  buildings  has  three  stories  and  a 
basement  and  is  one  hundred  and  forty  feet  long  bjy  sixty-six  feet  wide. 
The  well-aired  and  lighted  basement  is  devoted  to  rectal  and  bowel  ap- 
plications and  classrooms;  the  first  floor,  to  all  forms  of  general  and  local 
hydriatic  applications.  At  the  east  end  is  a  fine  swimming-pool  which 
is  maintained  at  a  temperature  of  about  78  degrees  F.  A  smaller  pool  has 
a  temperature  of  60  degrees  F. 

The   Electric   Light   Bath 

On  the  first  floor  are  found  the  various  forms  of  the  electric-light  bath,— 
one  of  the  most  important  additions  to  modern  therapeutics,  and  one  of  the 
many  outgrowths  of  the  experience  of  the  Battle  Creek  Sanitarium.  Here 
also  are  various  sprays  and  douches,  including  several  fine  steam  douches, 
by  which  most  excellent  revulsive  effects  can  be  produced,  and  a  giant 
douche  which  pours  down  a  perfect  torrent  of  water  at  a  temperature  a 
little  above  50  degrees  F.,  thus  giving  a  range  of  effects  suitable  to  every 
possible  case. 

That  hydrotherapy  has  won  a  definite  and  permanent  place  in  modern 
rational  therapeutics  can  no  longer  be  questioned,  and  the  Battle  Creek 
Sanitarium  claims  recognition  as  the  pioneer  in  scientific  hydrotherapy 
among  the  medical  institutions  of  this  country.  Here  have  been  developed 
a  great  number  of  additions  to  the  methods  and  technique  of  this  invabi- 
able  therapeutic  method. 

Physiologic    Tonics 

As  a  tonic,  cold  water  has  no  superior.  The  cold  spinal  douche  often 
accomplishes  marvelous  results  and  in  a  wonderfully  short  space  of  time 
in  certain  classes  of  neurasthenics.  The  tonic  sitz  baths,  cold  mitten  fric- 
tions, salt  glows,  towel  rubs,  wet  sheet  rubs,  wet  and  dry  packings,  com- 
presses, and  full  baths  of  various  sorts,  including  Nauheim  baths,  eiectro- 
hydric  baths,  shallow  and  neutral  baths,  are  only  a  few  of  the  numerous 
hydriatic  procedures  which  are  daily  in  effective  use  as  a  part  of  the  Battle 
Creek  Sanitarium  System. 

Electro-Hydric  Baths  and   Massages 

The  second  floor  of  each  of  the  treatment  buildings  is  devoted  chiefly 
to  electrical  baths,  massage,  and  local  applications  of  heat  by  means  of  the 
electric  thermophore,  the  photophore,  and  the  arc-light.  A  large  semi- 
circular space  is  devoted  to  manual  Swedish  Movements. 

The   Physiologic   Effects   of   Hydriatic   Applications 

In  scientific  hydrotherapy,  every  therapeutic  application  of  water  is 
based  upon  a  knowledge  of  the  physiologic  effects  of  the  given  application 
as  worked  out  by  careful  laboratory  research. 

63 


64 


THE    BATTLE    CREEK    SANITARIUM 

These  researches  have  shown  that  both  heat  and  t-ohl  may  be  employed 
in  such  a  way  as  to  produce  profound  effects,  both  excitant  and  depressant, 
not  only  upon  the  skin,  with  which  the  applications  are  brought  into  direct 
contact,  but  upon  every  organ  and  function  of  the  body.  Most  profound 
effects  may  be  produced  by  suitable  application,  upon  the  heart  and  circu- 
lation, the  absorption  of  oxygen  by  the  lungs  and  oxidation  processes  in  the 
tissues,  heat  production  and  elimination,  absorption  and  metabolism,  liver 
action,  renal  activity,  gastric  and  intestinal  secretions  and  motility,  hema- 
togenesis,  phagocytosis,  and  general  vital  resistance.  By  suitable  appli- 
cations, either  hot  or  cold,  or  hot  and  cold  in  alternation,  most  profound  reflex 
effects  may  be  produced,  inducing  vasodilatation  or  vasoconstriction  in  every 
important  bodily  viscus,  thus  exciting  or  depressing  activity  of  the  heart, 
the  brain,  and  the  spinal  cord,  the  stomach,  the  intestines,  the  bladder,  the 
kidneys,  the  uterus,  or  any  organ  the  function  of  which  it  may  be  desired 
to  influence. 

A  complete  description  of  the  principles  and  technique  of  the  system  of 
hydrotherapy  which  has  been  developed  and  is  in  practical  operation  at  the 
Battle  Creek  Sanitarium  may  be  found  in  a  volume  entitled  "Rational 
Hydrotherapy."  This  system  includes  more  than  two  hundred  different 
applications. 


LOBBY    OF   ladies'    BATH    DEPARTMENT 


65 


WALKING   LEG  BATH 


CORRIDOR   IN    MEN^S   BATH 


MEN  'S    SWIMMING    POOL 

66 


UYDRIATIC  PRCCEDURES 

G7 


GS 


PHOTOTHERAPY 
G9 


THERMOTHERABY 
70 


PHOTOTHERAPY  AND   THERMOTHERAPY 

ins  department  employs  both  the  solar  light  and  the  electric 
light.  In  summer-time  the  solar  light  is  used  both  direct  and 
after  filtering  through  a  blue  glass  screen  (to  diminish  its 
intensity  when  required).  In  winter-time  the  arc  light  is 
chiefly  relied  upon  as  a  source  for  the  actinic  rays. 

Within  the  last  thirty  years  electricity  has  won  its  way  to 
the  front  rank  as  a  therapeutic  agent. 

The  electric  light  is  one  of  the  most  important  applications  in  the  cura- 
tive art. 

The  electric  light  is  applied  by  means  of  the  photophore,  the  incandes- 
cent electric-light  bath,  and  the  arc-light  bath. 

Electro-thermophores  of  various  sorts  are  also  in  use.  The  electro- 
thermophore  consists  of  pads,  compresses,  or  blankets  in  which  wires  are 
interwoven  which  are  heated  by  electricity.  Scores  of  these  are  in  constant 
use. 

Phototherapy 

Phototherapy  holds  a  very  prominent  place  in  the  Battle  Creek  Sani- 
tarium System.  It  is  here  that  the  incandescent  light  was  first  utilized 
as  a  therapeutic  means.  Here  the  first  electric-light  bath  was  constructed. 
The  original  model  devised  and  still  in  use  here  has  been  closely  followed  by 
those  who  have  employed  this  bath  in  various  parts  of  the  world.  At  the 
present  time,  this  important  therapeutic  means  is  recognized  and  utilized 
by  progressive  therapeutists  in  all  civilized  countries.  Thousands  are  in 
use  in  the  leading  hospitals  and  sanitariums  of  Europe,  and  the  value  of 
this  bath  is  rapidly  coming  into  recognition  in  this  country. 

The  Actinic  Ray 

Most  powerful  chemical  light  effects  are  now  obtainable  by  means  of  the 
quartz  lamp  which  has  recently  been  perfected.  This  light  gives  off  almost 
pure  chemical  rays  which  are  so  highly  active  that  it  is  not  safe  to  expose 
the  eyes  to  the  direct  action  of  the  light.  Exposure  of  the  skin  for  four  or 
five  minutes  produces  very  active  photo  dermititis  .wdthout  sensible  heat 
effects.  The  actinic  ray  is  found  extremely  valuable  for  derivative  effects 
in  applications  to  the  chest  in  cases  of  chronic  bronchitis  and  over  the  liver 
for  relief  of  hepatic  congestion.  It  is  useful  in  many  forms  of  sTan  diseases. 
It  may  be  applied  successfully  to  different  portions  of  the  sMri' until  the 
whole  surface  of  the  body  has  been  covered,  as  a-^  means  of  permanently 
increasing  the  surface  circulation.  The  actinic  ray  is  also  useful  in  various 
skin  affections,  particularly  psoriasis  and  acne. 

*'Thototherapy  and  Thermotherapy."  A  System  of  •:  PJwsiologi^'al'  Thera- 
peutics. Vol.  IX.  P.  Blaldston's  Sons  &^Co.,  Philadelphia,  19Ql.:-^Thoto- 
therapy  in  Chronic  Diseases,"  American  .Eieetrotherapeutic  Association,  Sept. 
13-16,  1904,    St.   Louis,  Mo.     Archives   of  Physiological   Therapy,  Feb.,   1905. 


72 


ELECTRICAL  DEPARTMENT* 

LECTRICITY  is  not  capable  of  accomplishing  half  the  mar- 
vels that  are  claimed  for  it  by  many  enthusiastic  electro- 
therapists,  but  it  is,  nevertheless,  an  extremely  valuable  thera- 
peutic agent,  especially  when  utilized  in  connection  with 
hydrotherapy,  thermotherapy,  and  other  physiologic  methods. 
By  itself,  its  usefulness  is  extremely  limited,  but  in  connec- 
tion with  other  physiologic  measures  this  agent  is  capable  of  securing  most 
excellent  results. 

The    Sinusoidal    Current 

The  form  of  electrical  current  most  in  use  here  is  the  sinusoidal.  This 
is  a  current,  the  peculiar  properties  of  which  were  discovered  in  this. in- 
stitution more  than  twenty-five  years  ago  and  described  in  a  scientific 
paper  published  soon  after  and  read  at  a  meeting  of  the  American  Medical 
Association. 

Dr.  d'Arsonval,  of  Paris,  some  years  later  made  the  same  discovery, 
and  to  him  is  due  the  credit  of  having  accurately  studied  and  described 
the  current  and  made  its  properties  known  to  the  world. 

This  current  has  the  advantage  of  being  painless  in  application,  even 
while  producing  the  most  vigorous  muscular  contractions.  It  is  employed 
as  a  means  of  passive  exercise,  especially  for  the  development  of  the 
muscles  of  the  back  in  spinal  curvatures,  and  the  muscles  of 
the  abdomen  in  cases  of  enteroptosis.  It  is  also  an  excellent  means  of 
exercising  paralyzed  muscles  when  they  have  not  reached  a  too  advanced 
stage  of  degeneration,  and  furnishes  a  convenient  method  of  inducing 
vigorous  passive  exercise  of  the  muscles  in  cases  of  obesity  and  diabetes  in 
which  the  patient  is  too  feeble  to  take  the  requisite  amount  of  exercise 
in  walking  or  other  means  of  muscular  activity. 

The  galvanic  current  is  largely  utilized  in  appropriate  cases ;  also  the 
faradic  current.  Some  of  the  methods  employed  in  the  use  of  the  galvanic 
current  it  is  believed  are  rendered  more  efficient  by  modifications  which 
have  grown  out  of  experience  in  the  use  of  this  agent  in  this  establishment, 
especially  in  connection  with  various  hydriatic  measures. 

The  static  current  provided  by  a  large  machine  (the  largest  ever  con- 
structed) is  found  extremely  useful  in  certain  classes  of  cases,  especially 
the  paresthesias  of  neurasthenia,  insomnia,  and  certain  forms  of  neuralgia. 


*"A  Discussion  of  Electrotherapeutic  Metliods,"  International  System  of 
Electrotherapeutics,  F.  A.  Davis  Company,  Publishers,  Philadelphia,  Pa. 

"Electrotherapeutics  in  Chronic  Maladies,"  International  Electrical  Congress, 
St.  Louis,  Mo.,  Sept.  22,  1904.    Modern  Medicine,  Oct.  and  Nov.,  1904. 

"Graphic  Study  of  Electrical  Currents  in  Relation  to  Therapeutics,  with 
Special  Reference"  to  the  Sinusoidal  Current."  Proceedings  of  the  American 
Electrotherapeutic  Association,  Chicago,  September,  1893. 


STATIC     ELECTRICAL     AXI)     II  I<;  IM'RKQUEXC  Y     DEPARTMENT 
74 


THE    BATTLE    CREEK    SANITARIUM 

The  high,  frequency  current  is  utilized  iu  eases  to  which  it  is  adapted. 
Although  the  full  value  of  this  form  of  electrical  current  is  not  yet  clearly 
determined,  it  has  certainly  proved  itself  capable  of  producing  some  very 
useful  therapeutic  results  in  relieving  pain  and  lowering  blood-pressure, 
and  in  certain  forms  of  skin  disease  and  certain  nervous  affections.  The 
apparatus  for  the  use  of  these  measures  are  the  best  that  can  be  obtained 
in  the  United  States  or  Europe,  including  Ruhmkorf  coils  and  all  accessory 
devices. 

The  X-Ray  Department 

Few  scientific  discoveries  have  contributed  more  to  the  advancement  of 
rational  medicine  than  that  of  the  X-ray.  By  means  of  the  mysterious  rays 
discovered  by  Roentgen,  it  is  possible  to  obtain  information  concerning  in- 
ternal parts  of  the  greatest  value.  The  great  attention  which  has  been  given 
to  this  subject  by  experts  in  various  parts  of  the  world  has  thrown  im- 
portant light  upon  a  great  number  of  internal  morbid  conditions  which 
were  previously  most  obscure  and  the  exact  diagnosis  of  which  was  often 
wholly  impossible. 

By  means  of  the  X-ray  it  is  now  possible  to  determine  the  presence  and 
location  of  tumors  of  the  brain.  Cancerous  growths  and  other  diseased 
conditions  in  the  bones,  as  well  as  injuries  to  the  bones  resulting  from 
accident,  and  congenital  defects,  may  now  be  studied  with  a  scrutiny  which 
in  former  times  was  possible  only  after  death.  Diseased  conditions  of  the 
lungs  may  be  shown  by  successful  use  of  the  X-ray  long  before  the  diseased 
condition  is  revealed  by  physical  signs  of  any  sort.  Various  morbid  con- 
ditions of  the  heart  and  other  internal  parts,  as  well  as  the  location  of 
foreign  bodies  which  have  been  swallowed,  may  be  determined. 

The   Bismuth   Meal 

One  of  the  most  useful  of  all  the  applications  of  the  X-ray  in  diagnosis 
is  the  bismuth  meal.  The  ordinary  test  meal  gives  exceedingly  valuable  in- 
formation concerning  the  digestive  work  of  the  stomach,  but  throws  very 
little  light  upon  the  motility  of  the  stomach;  that  is,  of  the  action  of  the 
stomach  itself  upon  the  foods.  It  has  come  to  be  recognized  more  and  more 
of  recent  years  that  a  large  measure  of  the  disorders  of  the  stomach  are  de- 
pendent upon  disturbances  in  its  muscular  activity  or  motility.  By  means 
of  the  bismuth  meal,  the  movements  of  the  stomach  as  well  as  those  of  the 
intestine  may  be  made  visible,  and  the  rate  of  movement  and  the  digestion  of 
foodstuffs  along  the  alimentary  canal  may  be  actively  noted. 

This  study  has  shown  that  the  alimentary  canal  is  divided  into  sections 
by  a  series  of  valves  and  folds  which  may  be  termed  gates.  A  study  of  di- 
gestive orders  in  the  light  of  the  information  which  the  X-ray  has  given  us 
through  this  new  means  of  investigation,  shows  that  nearly  all  the  digestive 
disorders  are  the  result  of  trouble  at  one  or  more  of  these  gates.  In  healthy 
digestion  the  food  moves  from  one  to  another  of  the  several  compartments, 
pausing  in  each  one  until  the  work  done  in  that  section  of  the  digestive  ap- 
paratus is  accomplished,  then  moving  on  to  the  next  compartment.  When 
a  gate  does  not  open  promptly,  stagnation  of  the  digesting  food  material 
occurs,  fermentations  and  putrefactions  take  place;  the  mucous  membrane 

75 


APPLICATION      OF      SINUSODIAL      ELECTRICITY 


THE    SINUSOIDAL    BATH — ELECTRICAL    GYMNASTICS 

7G 


TIJK    HATTI^K    ('i.KKK    SA  X ITAKI IIM 

becomes  diseased;  autointoxication  results,  and  vai'ious  grave .  disorders 
follow.  In  some  cases  infections  travel  up  from  the  lower  part  of  the  in- 
testine to  the  upper  part,  giving  rise  to  gall  stones,  ulceration  of  the  duo- 
denum, gastric  stasis,  and  ulcer,  and  other  morbid  conditions.  If,  on  the 
other  hand,  a  gate  is  too  widely  open,  the  foodstuffs  pass  too  (pnckly  along 
the  canal  and  digestion  is  incomplete. 

It  is  evidently  a  matter  of  the  utmost  importance  to  obtain  accurate 
information  concerning  the  condition  of  each  separate  part  of  the  alimen- 
tary canal,  and  every  case  of  chronic  indigestion  should  have  the  benefit  of 
this  thoroughgoing  method  of  examination. 

This  is  especially  true  in  relation  to  chronic  constipation,  which  has  here- 
tofore been  one  of  the  most  baffling  disorders  with  which  physicians  have  had 
to  deal.  By  means  of  the  bismuth  meal  it  is  possible  to  locate  the  exact  point 
of  fecal  stagnation  in  every  case  of  constipation.  This  exact  knowledge  has 
made  it  possible  to  provide  efficient  remedies.  These  comparatively  recent 
discoveries  have  made  it  possible  to  deal  successfully  with  practically  every 
case  of  indigestion  and  constipation,  no  matter  how  chronic  the  case  may 
be  or  how  intractable  it  may  have  been  to  treatment  previously  applied. 

Use   of   the   X-Ray   in   the   Treatment   of   Internal    Tumors 

One  of  the  most  interesting  and  important  advances  made  in  recent 
times  is  the  curative  use  of  the  X-ray  in  its  application  to  the  treatment 
of  internal  tumors.  It  has  long  been  known  that  the  X-ray  is  capable  of 
producing  marvelous  effects  in  the  destruction  of  morbid  tissues.  Hun- 
dreds of  external  cancers  and  other  growths  have  been  destroyed  by  this 
means,  but  it  was  applicable  only  to  growths  affecting  very  superficial 
parts.  The  rays  could  not  be  applied  with  a  sufficient  degree  of  intensity 
to  affect  deep-lying  parts  without  producing  destructive  effects  upon  tl;e 
skin,  which  made  the  remedy  as  bad,  or  even  worse  than  the  disease. 

Very  recently  methods  have  been  discovered  by  which  the  injury  to  the 
skin  may  be  prevented,  so  that  very  powerful  applications  of  the  X-ray 
may  be  made  to  the  deepest-lying  parts.  The  application  of  this  method  to 
fibroid  tumors  of  the  uterus  has  been  attended  with  great  success.  A 
large  number  of  tumors,  which  were  in  some  cases  recognized  as  inoper- 
able, have  been  made  to  disappear  and  patients  have  been  definitely  and 
premanently  cured.  This  method  does  not  altogether  take  the  place  of 
surgery,  except  in  cases  in  which,  because  of  diseases  of  the  heart  or  kid- 
neys, or  for  other  reasons,  surgical  measures  can  not  be  employed,  or  in 
which  the  patient  will  not  consent  to  the  operation.  Surgery,  while 
involving  somewhat  greater  risk,  is  a  speedy  method  of  effecting  a  cure  in 
cases  in  which  it  is  applicable.  The  X-ray  is  altogether  free  from  risk, 
but  is  somewhat  tedious,  requiring  repeated  applications  during  a  more  or 
less  prolonged  period. 

Stereoscopic    Radiographs 

By  the  aid  of  recent  inventions  it  has  become  possible  to  make  stere- 
oradiographs,  by  means  of  which  the  exact  form  and  location  of  internal 
parts  may  be  seen  almost  as  clearly  as  though  they  were  not  hidden  within 
the  body.    The  application  of  this  new  method  to  the  stomach  and  intestines 


78 


THE    BATTLE    CREEK    SANITARIUM 

has  been  chiefly  developed  in  the  Roentgen  laboratory  of  this  institution. 
In  the  accompanying  radiographs  may  be  seen  examples  of  stereoradio- 
graphy, the  appearance  of  which  under  a  carefully  adjusted  stereoscope 
will  be  found  to  be  exceedingly  interesting.  By  means  of  this  new  method 
great  exactness  in. diagnosis  is  now  possible  in. cases  which  were  formerly 
obscure. 


Thermo-Penetration,  or  Diathermy 

This  is  a  new  application  of  electricity  in  which  the  electrical  current  is 
transformed  into  heat  in  the  interior  of  the  body.  The  apparatus  consists 
of  a  device  for  producing  rapid  alternations  of  a  low  voltage  current  such  as 
is  used  for  ordinary  lighting  purposes.  The  alternations  may  reach  a  fre- 
quency as  great  as  three  million  per  second.  No  electrical  effects  are  ex- 
perienced whatever.  The  sensation  is  simply  that  of  a  glow  of  heat  felt  not 
upon  the  skin  but  deep  in  the  tissues.  By  proper  adjustment  of  the  elec- 
trodes, the  heat  can  be  concentrated  at  any  internal  point  desired.  The 
telnperature  of  internal  parts  may  be  raised  as  much  as  4°  or  5°  F.  By  this 
means  it  is  possible  to  produce  the  stimulating  and  pain-relieving  effects  of 
heat  in  deeply  seated  tissues  as  well  as  in  parts  lying  upon  or  near  the 
surface. 

Diathermy  is  found  to  be  specially  useful  in  relieving  the  pain  of  sciatica, 
lumbago,  tic  douloureux,  neuralgia,  nervous  headache,  and  even  the  terrific 
pains  of  locomotor  ataxia.  The  pain  of  gout  and  rheumatism  yields  readily 
to  its  influence.  Chronic  pleurisy,  pneumonia  and  asthma  usually  yield 
quickly  to  applications  of  diathermy.  It  is  useful  in  obesity  and  aids  in 
the  removal  of  exudates  in  the  pelvis  and  elsewhere.  It  has  yielded  ex- 
cellent results  in  insomnia  and  in  chronic  myocarditis. 

The    Roentgen    Cinematograph 

One  of  the  most  interesting,  and  not  least  important  of  recent  X-ray 
discoveries,  is  the  perfection  of  a  method  by  which  X-ray  representations 
may  be  made  of  the  stomach  and  other  internal  organs  at  work.  The  in- 
stallation of  this  important  and  expensive  device  provides  the  Battle  Creek 
Sanitarium  with  the  first  apparatus  of  the  sort  which  has  been  introduced 
into  this  country,  and  among  the  first  in  use  anywhere.  This  apparatus 
has  been  especially  modified  for  our  Roentgen  department  and  embodies 
important  improvements  which  have  been  developed  through  the  large  ex- 
perience of  our  laboratory  in  stereoradiography  of  the  stomach  and  intes- 
tines. The  motion  picture  of  the  stomach  enables  the  patient  to  see  his  own 
stomach  actually  at  work  and  enables  the  physician  to  discover  slight,  but 
very  important,  changes  produced  by  disease  which  can  not  be  detected 
in  any  other.  It  was  by  the  aid  of  this  method  that  a  diagnosis  was  ar- 
rived at  in  the  case  of  a  late  king  of  finance  whose  case  had  previously 
baffled  the  world's  greatest  experts  in  diagnosis.  On  an  adjacent  page 
may  be  seen  a  series  of  pictures  representing  a  complete  cycle  of  gastric 
movements  as  obtained  by  the  Roentgen  cinematograph. 


THE    BATTLE    CREEK    SANITARIUM 

Radium 

Almost  the  only  use  that  has  been  found  thus  far  for  this  remarkable 
substance  is  in  the  treatment  of  disease.  The  first  accounts  of  the  curative 
powers  of  radium  were  received  with  much  incredulity.  It  seemed  in- 
credible that  so  great  effects  could  be  produced  by  so  minute  quantities  of 
any  substance  as  those  employed  in  radium  treatment.  More  recent  studies 
of  the  subject  by  Von  Noorden,  Neusser,  Gudzent  and  numerous  other  in- 
vestigators have  proven  that  both  radium  and  the  still  more  mysterious  sub- 
stance derived  from  it,  radium  emanation,  are  capable  of  producing  wonder- 
ful effects  upon  the  human  body  both  in  health  and  in  disease. 

Gottlieb  noticed  in  1905  that  the  miners  working  in  the  cold,  damp 
radium  mines  of  Joachimsthal  were  free  from  rheumatism  and  neuralgia. 
Dautwitz,  the  government  physician  in  charge  of  the  great  radium  bath 
establishment  at  Joachimsthal.  confirmed  this  observation.  Von  Noorden  and 
Falta  reported  in  the  Medizinische  Klinik  for  January,  1911,  the  results 
of  radium  treatment  in  75  cases,  in  most  of  which  excellent  results  were 
obtained.  In  one  case  of  acute  rheumatism  of  eight  days'  standing  the 
fever  and  swelling  disappeared  after  the  second  application.  His,  of  Gas- 
tein,  reported  excellent  results  in  more  than  two-thirds  out  of  100  cases  of 
chronic  rheumatism.  Dautwitz  claims  that  a  cure  is  accomplished  in  four- 
fifths  of  all  the  cases  which  come  under  his  care  at  Joachimsthal. 

Soupalt  claims  for  radium  emanation  the  cure  of  joint  rheumatism  and 
hydrarthrosis. 

Neusser,  Saake  and  "Wilke  have  shoA^ii  that  artificial  radium  emanation 
baths  have  the  same  effects  as  those  produced  by  a  course  of  treatment  at 
Gastein  (natural  radium  baths). 

Favorable  results  from  radium  emanation  have  been  shown  in  the  treat- 
ment of  cases  of  neuralgia,  rheumatism,  arthritis  and  various  forms  of  skin 
disease  by  Deutmann,  Neusser  and  Bickel,  Hirschwalt,  Braunstein,  Gager 
and  others. 

Aschoff  has  shown  improvement  in  cases  of  pain  and  joint  disease  by 
radium  emanation. 

Caan  has  shown  that  radium  emanation  relieves  pain  in  carcinoma  and 
sarcoma  and  produces  other  good  results. 

Mendel  and  Frith  have  shown  good  results  from  the  injection  of  radium- 
active  water. 

Echert  reports  improvement  by  the  use  of  radium  in  solution  and  by 
injection  in  a  case  of  tubercular  arthritis. 

Eadium  is  employed  by  several  different  methods.  1.  By  the  application 
of  radium  to  the  skin  for  the  removal  of  neoplasms.  2.  By  imbedding 
radium  in  morbid  growths.  3.  By  injecting  solutions  of  radium  into  the 
diseased  parts.  4.  By  ionization  in  which  the  radium  is  carried  into  the 
tissues  by  an  electrical  current.  5.  By  taking  internally  solutions  of  radium 
or  radium  emanation.  6.  By  means  of  baths  in  radium-containing  water. 
7.   By  the  inhalation  of  radium  emanation  (Niton). 

The  inhalation  of  the  radium  emanation,  especially  in  connection  with 
the  use  of  radium  solutions  internally,  is  the  method  which  promises  the 
best  results  in  cases  in  which  general  constitutional  effects  are  desired,  as 
in  rheumatism,  obesity,  arteriosclerosis,  neurasthenia  and  insomnia. 


APPLICATION    OF   DIATHERMY 


ADMINISTRATION   OF   RADIUM   EMANATION 

82 


THE    BATTLE    CREEK    SANITARIUM 

The  effects  of  radium  are  believed  to  be  produced  chiefly  through  its 
influence  upon  the  metabolic  and  other  ferments  of  the  body.  Experiments 
of  G-udzent  and  others  have  shown  that  most  of  the  body  ferments  are  to 
a  remarkable  degree  activated  by  radium  emanation.  By  activating  the 
uricolytic  ferment  it  increases  the  solubility  of  the  uric  acid  and  so  promotes 
its  elimination  from  the  body.  By  activating  other  metabolic  ferments  it 
stimulates  all  the  nutritive  functions  and  particularly  the  burning  up  of 
waste  substances  and  tissue  toxins. 

The  apparatus  shown  in  the  accompanying  illustration  has  been  specially 
made  for  use  in  the  radium  department  of  the  institution  and  embodies 
certain  improvements  which  are  believed  to  be  a  very  great  advantage.  In 
two  particulars  especially,  this  apparatus  is  believed  to  be  superior  to  that 
which  has  been  heretofore  in  use:  1.  In  the  complete  and  perfect  purifi- 
cation of  the  air ;  and,  2.  In  the  combined  use  of  static  electricity,  by  means 
of  which  the  body  is  negatively  charged,  so  that  the  positive  particles  of  the 
inhaled  radium  emanation  are  retained  within  the  body,  thus  increasing 
their  effects. 

Clinical  Results  of  Radium  Treatment 

The  British  Medical  Journal,  the  IMiinchener  Medizinische  Wochenschrift, 
and  other  leading  medical  periodicals  are  constantly  publishing  new 
evidence  of  the  wonderful  curative  power  of  radium. 

Doctor  Grin  recently  reported  in  the  IMiinchener  Medizinische  Wochen- 
schrift, No.  52,  1911,  two  cases  of  Bright 's  disease  in  which,  through  the 
use  of  radium,  the  quantity  of  urine  was  more  than  doubled.  A  very 
marked  diuretic  effect  was  apparent  almost  immediately  after  beginning  the 
use  of  radium  emanation  solution,  and  the  maximum  effect  was  reached 
within  two  weeks. 

Armstrong,  a  member  of  the  Royal  College  of  Surgeons  of  England,  re- 
ports the  results  of  the  use  of  radium  emanation  in  over  400  cases.  Among 
the  most  notable  effects  observed  were  decrease  of  sugar  in  diabetes,  de- 
crease of  albumin  with  lowering  of  blood-pressure  and  increased  elimination 
of  waste  products  in  Bright 's  disease,  lowering  of  blood-pressure  in  arterio- 
sclerosis from  20  to  80  points,  rapid  decrease  of  pain  and  elimination  of 
uric  acid  in  gout,  relief  of  pain  and  stiffness  in  rheumatism,  rapid  improve- 
ment in  neuritis  and  arthritis,  extraordinarily  rapid  and  complete  beneficial 
effects  in  neurasthenia. 

Like  results  are  reported  by  Strassburger,  of  the  University  of  Breslau,  by 
Doctor  Dautwitz,  of  Joachimsthal,  and  by  Falta,  Freund,  Von  Noorden,  and 
others,  of  Vienna. 

Aero-Therapy  and  the  Hot  Air  Douche 

By  means  of  an  apparatus  designed  for  the  purpose,  air  in  the  form  of  a 
douche  may  be  employed.  Any  desired  degree  of  temperature  may  be  used ; 
hot  or  cold,  or  hot  and  cold  in  alternation. 

This  remedy  is  found  very  valuable  as  a  means  of  relieving  painful 
joints  and  the  pain  of  sciatica  and  as  a  means  of  producing  various  powerful 
derivative  effects  through  induced  hyperemia  of  the  skin. 

Cases  have  been  reported  in  which  gouty  nodules  were  absorbed  under 
its  use. 

83 


84 


PHYSICAL  TRAINING 


EALTIi  winning  by  means  of  exereis:e  occupies  a  very  im- 
portant place  among  the  Battle  Creek  Sanitarium  methods. 
Most  women  and  a  large  proportion  of  the  men  who  visit  the 
institution  are  suffering  from  deficient  development  of  the 
muscles,  particularly  the  abdominal  muscles. 

As  a  result  of  weakness  of  the  muscles  of  the  abdomen, 
there  is  prolapse  of  the  viscera,  and  a  lessening  of  intra-abdominal  pres- 
sure, which  permits  an  overdue  accumulation  of  blood  in  the  abdomen, 
to  the  detriment  both  of  the  abdominal  viscera  and  the  body  in  general. 

The  stomach,  liver,  bowels,  and  other  organs  contain  an  excess  of  blood, 
while  the  spinal  cord,  brain,  and  lungs  are  deprived  of  the  blood  needed 
for  their  proper  functioning. 

The  excess  of  blood  M^hich  accumulates  in  the  abdomen,  stagnating, 
loses  its  oxygen  and  becomes  charged  with  toxins,  and  the  bacteria  which 
flourish  in  the  alimentary  tract,  especially  in  the  colon,  give  rise  to  in- 
fections of  the  colon,  appendix,  gall-bladder,  and  even  more  remote  organs. 

The  overwhelming  quantity  of  toxins  poured  into  the  blood  gives  rise 
to  cirrhosis  of  the  liver,  degenerative  changes  in  the  kidneys,  arterioscler- 
osis, and  other  maladies.  It  is  believed  that  to  this  chronic  autointoxication 
may  be  traced  a  large  share  of  the  chronic  ailments  from  which  men  and 
women  suffer  and  die. 

Exercise  is  one  of  the  most  important  means  by  which  this  condition 
can  be  corrected.  When  the  abdomen  and  other  trunk  muscles  can  be 
properly  developed,  so  that  the  bowels  are  held  up  in  place  and  the  vessels 
of  the  great  splanchnic  area  receive  proper  support,  a  fundamental  cause 
of  a  multitude  of  human  maladies  and  miseries  is  permanently  removed. 

The  part  w^hich  the  congested  condition  of  the  viscera  plays  in  the  pro- 
duction of  functional,  nerve,  and  mental  disorders  has  been  well  shown  by 
many  observers,  and  has  been  here  demonstrated  in  hundreds  of  cases  in 
the  restoration  to  health  of  chronic  sufferers  who  apparently  could  be  re- 
lieved by  no  other  means. 

The  methods  employed  in  this  department  are  not  gymnastic  only,  but 
involve  the  correction  of  faulty  dress,  faulty  habits  in  sitting,  standing, 
walking,  etc.,  by  means  of  daily  drills. 

The  Sanitarium  Chair 

As  soon  as  the  patient  arrives  at  the  Battle  Creek  Sanitarium,  his 
training  begins.  He  is  made  to  sit  erect,  with  the  chest  high  and  the  ab- 
dominal muscles  drawn  in,  by  being  provided  with  chairs  in  which  he  is 
enabled  to  sit  erect  without  effort.  The  Sanitarium  health  chair  supports 
the  center  of  the  back  so  that  the  chest  is  held  erect. 

In  the  gymnasium  the  patient  is  taught  to  stand  correctly,  mth  the 
chest  held  high,  the  chin  draM^n  in,  the  hips  held  back,  and  the  abdominal 
muscles  tense.     In  this  position  he  takes  various  exercises  with  the  arms, 

85 


MEDICAL     GYMNASTICS 

86 


THE    BATTLE    CREEK    SANITARIUM 

limbs,  and  trunk,  until  the  muscles  of  the  back  are  so  strengthened  that 
they  are  able  to  hold  the  body  in  correct  position. 

For  those  in  whom  the  muscles  are  so  attenuated  that  the  desired  result 
can  not  be  accomplished  by  gymnastic  exercises,  manual  Swedish  move- 
ments and  the  sinusoidal  electrical  current  are  called  upon  to  accomplish 
the  first  stages  of  the  cure. 

It  is  exceedingly  interesting  to  note  the  rapidity  with  which  the  muscles 
acquire  strength  and  vigor  when  a  variety  of  means  for  improving  their 
condition  are  set  in  operation  and  applied  several  times  daily  in  an  ef- 
fective manner.     An  application  once  or  twice  a  week  amounts  to  almost 


THE    SANITARIUM    CHAIR 

nothing  in  the  direction  of  development.     The  applications  must  be  short, 
efficient,  and  frequently  repeated ;  that  is,  several  times  each  day. 

Swimming 

Patients  are  encouraged  to  learn  to  swim,  not  only  for  the  tonic  effect 
of  the  swimming  bath  and  the  aid  to  respiration  and  circulation,  but 
especially  for  the  purpose  of  strengthening  the  trunk  muscles  and  thus 
restoring  the  normal  tone  of  the  walls  of  the  abdomen,  and  the  intra-ab- 
dominal pressure,  upon  which  the  proper  distribution  of  the  blood  through- 
out the  body  is  almost  as  much  dependent  as  upon  the  movements  of  the 
heart. 

The  Exercise  Prescription 

The  accompanying  cut  will  give  something  of  an  idea  of  how  these 
various  measures  are  put  in  operation  to  accomplish  the  desired  end. 
Careful  examination  of  the  program  for  the  invalid's  day  will  show  how 

87 


MEDICAL     GYMNASTICS 

88 


THE    BATTLE    CREEK    SANITARIUM 

large  a  part  gymnastics  play  in  this  therapeutic  system.  Nothing  is 
left  to  whim  or  fancy,  and  no  i)resci'iption  for  exercise  is  made  until  the 
patient's  strength  has  been  thoroughly  tested  and  his  chart  has  been  made 
out.  With  this  before  him,  the  physician  or  physical  director  assigns 
work  which  is  suited  to  each  case.  The  exercises  taken  in  general  classes 
are  of  such  a  character  as  to  be  suited  to  nearly  all.  In  addition  to  this, 
individual  work  is  marked  out  which  is  chiefly  depended  upon  for  correct- 
ive development. 

There  are  special  exercise  classes  for  feeble  patients,  and  the  very 
feeblest  are  visited  in  their  rooms.  Even  bedridden  patients,  not  ex- 
cluding the  convalescents  of  the  surgical  ward,  are  visited  several  times 
daily  and  directed  in  taking  various  deep-breathing  movements  which 
are  especially  adapted  to  their  individual  cases. 

The  exercise  taken  before  and  after  breakfast,  after  dinner,  and  after 
supper  in  the  evening,  are  especially  designed  to  aid  digestion  by  promot- 
ing the  movement  of  blood  through  the  abdominal  viscera  and  preventing 
congestion  or  stasis  in  this  region. 

Manual    Swedish    Movements    or    Medical    Gymnastics 

More  than  one  hundred  years  ago  Ling,  of  Sweden,  by  the  study  of 
a  French  translation  of  an  ancient  Chinese  book,  became  accpainted 
with  some  methods  employed  from  ancient  times  by  the  Chinese  in  train- 
ing soldiers  for  war.  Taking  the  Chinese  system  as  a  foundation,  he  de- 
veloped the  most  scientific  system  of  gymnastics  which  the  world  knows 
anything  about. 

Ling,  who  was  an  officer  in  the  Swedish  army,  succeeded  in  getting  his 
system  adopted  by  the  Swedish  government,  which  erected  a  large  building 
for  purpose  of  instruction;  and  now  for  three-quarters  of  a  century  this 
method  has  been  in  use  not  only  in  the  Swedish  army,  but  in  the  public 
schools  of  Sweden,  and  has  resulted  in  the  development  of  a  magnificent 
race  of  men  and  women.  Any  traveler  who  has  visited  Stockholm  must 
have  been  struck  by  the  remarkably  large  number  of  fine,  athletic-looking 
men  whom  he  met  upon  the  streets.  It  is  almost  impossible  to  find  a 
Swede  who  is  not  an  athlete. 

Every  officer  in  the  Swedish  army  is  required  to  have  a  practical  knowl- 
edge of  the  medical  Swedish  gymnastics,  or  the  so-called  manual  Swedish 
movements. 

The  system  has  been  in  use  at  the  Battle  Creek  Sanitarium  for  many 
years.  Nearly  thirty  years  ago  a  physician  was  sent  to  Stockholm  to 
become  acquainted  with  the  system,  and  trained  Swedish  experts  were 
brought  to  the  institution  to  assist  in  introducing  it.  Recently  this  system 
has  been  rapidly  growing  in  favor  in  this  country  under  various  names 
other  than  its  own.  So-called  osteopathy  is  a  modification  of  the  Swedish 
system  which  has  yet  to  demonstrate  its  superiority,  or  its  claim  to  be 
called  a  system  or  a  new  scientific  method. 

This  department  is  under  charge  of  a  physician  trained  in  Sweden. 

Swedish  Gymnastics  For  Women 

The  Swedish  method  is  especially  valuable  for  the  treatment  of  men 
and  women  suffering  from  sedentary  habits.     It  affords  the  most  satis- 

89 


MASSAGE 

90 


THE    BATTLE    CREEK    SANITARIUM 

factory  and  efficient  means  known  for  developing  the  abdominal  muscles 
of  the  trunk,  especially  in  connection  with  the  use  of  electricity  and  hydro- 
therapy; and,  with  special  breathing  exercises  and  abdominal  movements, 
produces  a  most  highly  beneficial  effect  upon  the  abdominal  viscera,  re- 
lieving stasis,  emptying  the  stomach,  liver,  and  other  viscera  of  stagnating 
blood,  and  thus  improving  functional  activity. 

The  accompanying  cuts  show  some  of  the  movements  which  are  found 
most  valuable  in  connection  with  the  numerous  other  physiologic  measures 
employed  in  the  Sanitarium  system. 

The  manual  Swedish  movement  comprises  an  extensive  and  almost 
endless  variety  of  most  carefully  and  accurately  graduated  exercises ;  some 
passive,  others  active,  and  still  others  active-passive.  These  are  arranged 
in  graduated  series,  known  as  ''day's  orders,"  which  represents  the  work 
for  one  day.  Each  day  the  patient  makes  a  little  progress,  though  very 
feeble  patients  may  not  be  able  to  execute  the  whole  order  the  first  day  the 
treatment  is  given.     Special  attention  is  given  to  deep-breathing  exercises. 

Day's  Order  for  a  Person  Suffering  from  Enteroptosis 

Here  is  a  sample  "day's  order"  for  a  patient  suffering  from  enter- 
optosis. the  first  of  a  series  of  ten : — 

In  executing  the  following  Day's  Orders,  a  breathing  exercise  should  be 
taken  before  each  movement.  During  each  movement  the  chest  should  be 
held  high,  and  the  breath  should  be  forced  out  by  strong  contractions  of  the 
abdominal  muscles. 

NUTRITIVE 
Day's  Order  No.  1. 

1.  Breathing  Exercise  Series  1,  Exercise  1 — Abdominal  kneading. 

2.  Breathing  Exercise  Series  1,  Exercise  2 — Prone  lying,  spinal-column- 

hacking. 

3.  Breathing  Exercise  Series  1,  Exercise  3 — Lying,  foot  rolling. 

A.    Breathing  Exercise  Series  1,  Exercise  4 — Lying,  arm-side  wise-extended, 
arm-shaking. 

5.  Breathing  Exercise  Series  1,  Exercise  5 — Lying,  legs-nerve-pressing. 

6.  Breathing  Exercise  Series  1,  Exercise  6 — Crook-lying,  vibration  under 

left  ribs,  percussion  over  ribs. 

7.  Breathing  Exercise  Series  1,  Exercise  7 — Prone-lying,  sacrum-beating. 

8.  Breathing  Exercise  Series  1,  Exercise  8 — Lying,  leg-shaking. 

9.  Breathing  Exercise  Series  1,  Exercise  9 — Lying,  nerve-compression-ab- 

dominal-sympathetic. 
10.    Breathing  Exercise  Series  1,  Exercise  10 — Lying,  head-tapping  and 
stroking. 

BREATHING  EXERCISES 

Series  I,  Lying;    Series  II,  Sitting;    Series  III,  Standing. 

The  following  exercises  are  to  be  taken  in  each  of  the  positions,  lying, 
sitting  and  standing.  The  patients  who  are  to  take  these  exercises  should  be 
instructed  to  practise  breathing  lying  upon  the  face  for  at  least  fifteen 

91 


92 


THE    BATTLE    CREEK    SANITARIUM 

minutes,  three  times  a  day,  and  to  ad()])t  the  practice  of  sleeping  in  the  prone 
position  (on  the  face). 

Series  I. 

1.  Full  Breathing.  Take  shnv,  deep  inspiration  through  the  nose,  ex- 
panding the  whole  trunk,  complete  the  prolonged  expiration  through  com- 
pressed lips.  (20.) 

2.  Abdominal  Breathing.  Chest  high,  hands  on  hips,  thumbs  to  rear. 
Contract  abdominal  muscles  with  strong  expiratory  effort ;  press  hard  with 
thumbs  upon  the  lower  back  to  hold  chest  up  during  expiration.  (10.) 

3.  Assisted  Abdominal  BrcatJiing.  Chest  high,  hands  holding  abdomen, 
deep  abdominal  breathing.  (2),  (10.) 

4.  Chest  Lifting.  After  complete  expiration,  close  throat  and  lift  chest 
high  as  possible,  followed  by  full  breathing.  (1),  (2,  5.) 

5.  Chest  Lifting,  Arms  Raising.  Chest  high,  deep  abdominal  breathing 
(2),  arms  raised  above  head.  (10.) 

6.  Chest  Lifting,  Arms  Circumduction.  Chest  high,  deep  abdominal 
breathing  (1),  arms  circumduction.    (10.) 

7.  Chest  Lifting,  Feet  Extension.  Chest  high,  deep  abdominal  breath- 
ing (2),  arms  raising  and  feet  extension.    (10.) 

8.  Chest  Lifting,  Arms  Raising,  Feet  Extension.  Chest  high,  deep 
abdominal  breathing  (2),  arms  raising  and  feet  extension  (10). 

9.  Chest  Lifting,  Swimming.  Chest  high,  deep  abdominal  breath- 
ing (2),  swimming  movements  with  arms  (10). 

10.  Chest  Lifting,  Swimming.  Chest  high,  deep  abdominal  breathing 
(2),  swimming  movements  arms  and  legs  (10). 

Series  II. 

Execute  the  above  movements  in  the  sitting  position  as  above  described 
in  section  10,  in  which  knee-raising  is  substituted  for  leg  movements. 

Series  III. 

Execute  the  above  movements  in  the  standing  position  as  described  with 
exception  of  seven  and  eight,  in  which  walking  on  the  toes  is  substituted  for 
feet  extension. 

The  standing  position  taken  in  breathing  exercises  should  be :  Heels  and 
hips  against  a  wall,  door-jamb,  or  the  edge  of  a  door,  the  chest  being  held 
forward  as  far  as  possible  without  losing  the  balance. 

Mechanotherapy  or  Mechanical  Exercise 

Certain  forms  of  passive  exercise  may  be  administered  by  machinery 
far  more  effectively  than  by  the  hand.  This  is  particularly  true  of  vibra- 
tory exercise.  The  rapid,  steady,  and  prolonged  vibratory  movements 
which  can  be  administered  by  machinery  can  not  be  even  approximated  in 
efficiency  by  the  human  hand.  Certain  kneading  and  percussion  move- 
ments may  be  administered  more  effectively  by  mechanical  means  than 
by  the  manual  method. 

93 


MEGHANOTHEEAPY — VIBROTHERAPY 

94 


THE    BATTLE    CREEK    SANITARIUM 

For  more  than  thirty  years  this  method  has  been  employed  in  the 
Battle  Creek  Sanitarium,  and  the  apparatus  found  in  this  department 
represents  the  perfected  result  of  these  many  years'  experience,  having 
been  specially  constructed  for  this  use.  For  more  than  twenty  years  the 
institution  has  maintained  a  fully  equipped  machine  shop,  which  has  been 
largely  occupied  with  the  work  of  developing  and  manufacturing  the 
special  apparatus  employed  in  this  and  other  departments. 

Various  series  of  graduated  movements  are  prepared  for  different  mal- 
adies and  conditions,  as  obesity,  constipation,  neurasthenia,  cardiac  cases, 
etc. 

Vibrotherapy 

This  mode  of  passive  exercise,  certain  phases  of  which  have  recently 
been  so  extensively  exploited  throughout  the  country,  has  been  in  use  as  a 
part  of  the  Battle  Creek  Sanitarium  System  for  more  than  forty  years. 
This  department  is  represented  by  special  vibrators  for  the  hands  and 
arms,  vibrators  for  the  feet,  vibrating  stools,  vibrating  tables,  the  vibrating 
chair,  and  sets  of  vibrating  chairs  in  which  several  patients  may  be  treated 
at  once. 

So  many  absurd  claims  have  been  made  for  vibrotherapy  that  doubts 
will  naturally  arise  in  the  minds  of  many  physicians  respecting  its  actual 
value.  Experience,  however,  has  demonstrated  its  efficiency  in  the  ac- 
complishment of  certain  things. 

Each  of  the  three  forms  of  vibration — percutient,  lateral,  and  centrif- 
ugal— produces  characteristic  effects  which  have  been  studied  by  Vigor- 
oux,  Mortimer  Granville,  Sehiff,  Boudet,  and  other  investigators;  and  it 
has  been  shown  that  this  measure  is  capable  of  increasing  or  diminishing 
nervous  sensibility.  It  may  produce  fatigue,  as  does  muscular  work;  or 
may  abolish  the  sense  of  fatigue  by  stimulation  of  the  spinal  centers. 
Applied  to  the  head  it  may  produce  drowsiness,  and  even  sleep.  Applied 
to  the  muscles  it  may  produce  contraction  or  relaxation.  It  may  produce 
vasomotor  changes  in  the  viscera,  and  even  raise  and  lower  blood-pressure. 
A  thorough  discussion  of  rational  vibrotherapy,  its  physiologic  effects  and 
therapeutic  indications,  will  be  found  in  medical  papers  appearing  else- 
where.* 

Mechanical    Massage 

The  vigorous,  steady  rhythm  of  mechanical  massage  and  its  never-tiring 
thoroughness  are  qualities  which  secure  splendid  results  not  to  be  obtained 
by  manual  means.  The  various  forms  of  loieaders  employed  adapt  this 
method  not  only  to  the  abdomen,  but  to  all  the  fleshy  parts  of  the  body. 

Patients  often  express  themselves  as  feeling  that  they  get  more  immedi- 
ate return  from  the  treatment  in  this  department  than  any  other.  The 
neurasthenic  who  suffers  from  cold  hands  and  feet  finds  his  extremities 
glowing  with  warmth  after  a  few  moments'  application  of  hand  and  foot 
vibration.    The  vasomotor  spasm  has  been  broken  by  the  rapid  mechanical 


*See    Modern    Medicine    for    1908.       Good    Health    Publishing    Co.,    Battle 
Creek,  Mich. 

95 


MECHANOTHERAPY 

96 


THE    BATTLE    CREEK    SANITARIUM 

movement.  The  improved  distribution  of  blood  relieves  congestion  of 
the  brain  and  spinal  cord,  as  well  as  the  general  visceral  stasis ;  and  a  sense 
of  well-being,  comfort  and  relief  gives  place  to  the  depression,  nervousness, 
confusion,  and  general  discomfort  which  are  the  natural  result  of  a  dis- 
ordered condition  of  the  circulation, 

A  great  share  of  the  aches  and  indefinable  distresses  from  which  neu- 
rasthenics suffer  are  generally  temporaril.v  relieved,  and  often  in  a  manner 
which  seems  almost  magical. 

The  efifects  which  can  be  obtained  liy  this  method  must  not  be  judged 
by  the  disappointing  results  produced  from  the  use  of  various  trinkets 
which  are  hawked  about  the  country  under  the  name  of  vibrators,  few  of 
which  are  sufficiently  effective  to  produce  any  definite  results  whatever. 

Other  useful  devices  for  the  employment  of  mechanotherapy  which  may 
be  mentioned  are  the  following : 

The  Riding  Horse,  of  which  two  styles  are  in  use,  one  of  which  is  a  very 
excellent  imitation  of  the  single-foot,  while  the  other  is  a  very  perfect  simu- 
lation of  the  English  trot. 

The  Camel — A  device  which  produces  a  peculiar  rolling  motion 
characteristic  of  the  camel's  gait. 

Mechanical  Massage  op  the  Back — An  ingenious  arrangement  by 
which  kneading  movements  are  applied  to  the  back.  Very  effective  as  a 
means  of  stimulating  the  development  of  the  muscles  of  the  back,  and  pro- 
ducing an  excellent  derivative  effect  in  relation  to  the  internal  viscera. 

Percussion  Massage — An  apparatus  for  applying  light  percussion,  very 
closely  imitating  certain  forms  of  percussion  movements  which  may  be  ap- 
plied by  the  hands.  The  mechanical  percussion  is  even  more  effective  than 
that  of  the  hands,  and  is  uniform  and  steady.  The  force  of  the  percussion 
movements  may  be  very  easily  adjusted.  An  excellent  application  for  the 
shoulders,  chest,  and  back. 

Rotary  Massage  op  the  Abdomen — An  apparatus  which  applies  a  ro- 
tary kneading  movement  to  the  abdomen  in  a  circular  manner.  An  excellent 
means  of  relieving  constipation. 

The  Ergograph — A  device  by  means  of  which  the  actual  amount  of  work 
done  is  measured  and  recorded  for  special  use  in  cases  in  which  a  specific 
amount  is  necessary,  as  in  the  treatment  of  certain  forms  of  obesity. 

Besides  the  above,  there  are  numerous  other  measures  which  are 
specially  designed  to  develop  the  chest,  to  aid  in  the  breathing  movements, 
and  to  develop  the  muscles  of  the  trunk. 


97 


APPARATUS  FOR  AUTOMATIC  EXERCISE 

98 


OPEN-AIR  AND  COLD-AIR  METHODS 


^|]  HE  open-air  method  has  always  been  a  prominent  feature  in  the 
Battle  Creek  Sanitarium  System, 

Two  large  outdoor  gymnasiums  are  provided,  one  for  men 
and  one  for  women.  The  gymnasium  for  women  is  near  the 
ladies'  bathroom.  The  men's  outdoor  gymnasium  is  on  the 
opposite  side  of  the  grounds,  sufficiently  removed  from .  the 
main  building  to  secure  the  necessary  seclusion.  The  opportunities  for 
open-air  treatments  afforded  by  the  outdoor  gymnasiums  are  regarded  as 
among  the  most  valuable  of  the  various  curative  resources  afforded  by  the 
institution.  The  sand  pile,  pure  white  sand  from  pulverized  flint,  such  as 
is  used  in  glass  making,  the  seclusion  affording  opportunity  for  the  free 
exposure  of  the  skin  to  light  and  air,  the  running  path,  the  wood  pile,  the 
swimming  pool,  the  exercise  apparatus  and  provision  for  games  of  various 
sorts,  secure  all  the  advantages  of  the  seashore,  and  even  more. 

By  this  means  the  circulation  of  the  skin  is  stimulated.  The  proof  of 
the  effects  of  the  sun's  rays  upon  the  skin  is  to  be  found  in  the  pigmenta- 
tion and  heightened  color  which  develop  rapidly  after  a  few  exposures. 
First  exposures  are  sometimes  followed  by  slight  attacks  of  erythema, 
which  do  no  harm,  but  may  in  fact  enhance  the  beneficial  effects. 

The  skin  is  capable  of  holding  two-thirds  of  all  the  blood  in  the  body. 
When  it  is  inactive  and  empty,  the  necessary  result  is  that  the  liver  and 
other  viscera  are  congested,  and  stasis  exists  in  the  whole  splanchnic  area. 

The   Outdoor  Gymnasium 

Exposure  to  cool  air  also  stimulates  the  activity  of  the  skin.  Exercise 
of  the  body  relieved  of  trammels  of  every  sort  brings  each  muscle  into  nor- 
mal play.  After  being  well  warmed  by  exercise,  the  patient  enjoys  a 
plunge  into  the  clear  fresh  water  of  the  swimming  pool,  just  cool  enough 
to  be  refreshing  and  invigorating. 

During  the  summer  months,  manual  Swedish  gymnastics  and  a  great 
variety  of  exercises,  some  of  which,  though  long  used  in  the  Battle  Creek 
System  and  utilized  for  a  hundred  years  in  Sweden,  are  just  now  becoming 
familiar  to  the  public  under  the  names  of  "Osteopathy,"  "Movements," 
etc.,  and  are  administered  in  the  free  air  of  the  outdoor  gymnasium.  Patients 
chop  wood,  saw  wood,  play  at  basket-ball,  ' '  volley-ball, ' '  and  other  simple 
games,  walk  and  trot  around  the  running  path,  take  swimming  lessons, 
and  engage  in  all  kinds  of  exercises  without  other  covering  than  simple 
trunks,  so  that  the  skin  becomes  hardened,  toughened,  and  in  many  cases 
as  brown  as  that  of  a  North  American  Indian. 

The  effects  of  such  tanning  and  hardening  of  the  skin  upon  the  internal 
organs  are  in  the  highest  degree  beneficial.  Appetite  and  digestion  im- 
prove, heart  vigor  increases,  hepatic  and  renal  activity  are  encouraged, 
normal  metabolism  is  encouraged,  and  the  patient  feels  daily  the  growth  of 

99 


sfftiii    pfffiti    ^niiffi    Hitiiit    wiitfin 


r-^-tti     inrfffi'"  f^iii^  ■-iitff^r-~->ififr 


CUTDCCK    CALISTHENICS 

100 


FRESH   AIE    CURE 
101 


FRESH  AIR  SLEEPING  ARRAXGEMEXTS 

102 


THE    BATTLE    CREEK    SANITARIUM 

new  life  and  vigor  under  the   stimulus  of  the  natural  forces  by  which 
the  body  is  created  and  maintained. 

Thus  all  the  best  advantages  of  the  seashore,  camping  out,  "going 
fishing,"  and  other  forms  of  recreation  are  secured,  while  the  patient  is 
protected  from  excess  by  the  careful  guidance  of  his  physician,  and  has 
the  advantages  of  medical  care,  dietetic  regulation,  etc.,  in  addition. 

Walking  Parties 

Outdoor  walking  parties  are  greatly  in  vogue  and  are  a  source  of  great 
pleasure  as  well  as  profit.  These  parties  are  accompanied  by  a  physical 
director  or  a  naturalist  who  knows  all  the  birds  and  trees,  and  expounds  to 
the  uninitiated  the  teachings  of  the  great  book  of  Nature. 

The  invalid's  dread  of  cold  weather  is  really  a  dread  of  chilling  or 
getting  cold, — a  dangerous  thing  for  sick  folks.  That,  however,  is  quite 
another  matter.  The  invalid  should  breathe  cold  air,  but  he  should  be 
kept  warm.  The  ideal  is  cold  air  for  the  lungs,  warmth  for  the  rest  of 
the  body. 

The  Arctic  explorer  requires  a  large  ration,  not  so  much  to  keep  his 
hands  and  feet  warm,  for  he  clothes  himself  so  warmly  that  even  the 
searching  Arctic  cold  can  not  reach  him,  but  because  he  breathes  cold  air. 

Open-Air  Sleeping   Arrangements 

Open-air  sleeping  arrangements  are  provided  for  those  who  can  be  in- 
duced to  use  them.  There  are  special  sleeping  porches  for  ladies.  Here 
those  who  enjoy  sleeping  in  the  open  air  are  snugly  tucked  away  by  the 
nurses,  wrapped  as  warmly  as  for  a  sleigh-ride  in  the  polar  regions,  and 
protected,  if  need  be,  by  hot-water  bags,  or  thermoelectric  blankets,  which 
furnish  heat  in  any  amount  as  long  as  desired, — warmth  on  tap  like  water ; 
just  touch  a  button  and  the  bed  warms  up  at  once. 

Watchful  nurses  are  at  hand  ready  to  give  any  needed  assistance. 

There  are  sleeping  bags  and  hoods  for  those  who  wish  them.  They 
keep  the  body  as  warm  as  toast  all  night  long,  and  allow  the  pure  cold  air 
to  be  inhaled  without  fear  of  chilling  or  of  "catching  cold." 

The  window  tent  is  an  ingenious  invention  by  the  aid  of  which  the 
sick  person  may  have  all  the  advantages  of  the  pure  cold  air  without  go- 
ing out  of  doors.  By  this  plan  the  head  is  outdoors  while  the  rest  of  the 
body  remains  warm  and  comfortable  indoors. 

The  fresh-air  tube  is  a  Sanitarium  device  for  conveying  fresh  air  to  the 
patient  from  an  adjoining  window.  It  works  well,  and  is  adaptable  to  any 
room  and  to  all  possible  conditions.  The  patient  may  breathe  the  coldest  of 
winter  air  while  snugly  tucked  away  in  his  cozy  sleeping-room.  "With 
this  device  he  gets  all  the  advantages  of  the  pure  cold  air  with  none  of  the 
inconveniences  or  possible  risk  of  out-of-door  sleeping. 

Out-of-Door  Attractions 

Skating,  tobogganing,  skeeing,  and  other  outdoor  sports  invite  those 
who  are  strong  enough  to  enjoy  them.  There  is  always  ice,  and  usually 
plenty  of  snow,  during  the  mid-winter  season  in  the  Peninsular  State. 

103 


FKESH  AIR  SLEEPING  ARRANGEMENTS 
104 


THE    BATTLE    CREEK    SANITARIUM 

Many  of  the  patients  enjoy  a  whccl-cluiir  outing  on  tl)(^  long  porches. 
The  nurses  bundle  them  up  warmly,  and  back  and  forth  they  go 
under  the  long  porticos,  chatting  with  one  another  as  they  pass,  enjoying 
the  outdoor  life  and  taking  long  breaths  of  the  vitalizing  oxygen. 

The    Faculty    of   the    Sanitarium 

The  corps  of  physicians  consists  of  more  than  twenty  thoroughly  trained 
medical  men  and  women,  all  of  whom  have  been  specially  trained  for  Sani- 
tarium work,  and  have  had  many  years  of  experience  in  the  institution. 
All  these  physicians  are  graduates  from  first-class  medical  schools.  Some 
have  received  honors  and  diplomas  from  the  highest  medical  authorities 
and  organizations. 

Battle  Creek  Sanitarium  Faculty 

J.  H.  Kellogg,  M.  D.,  F.  R.  S.  M.,  Supt Surgeon 

W.  H.  Riley,  M.  S.,  M.  D Neurologist 

C.  E.  Stewart,  M.  D Internal  Medicine 

E.  L.  Eggleston,  M.  D Internal  Medicine 

R.  H.  Harris,  M.  D.,  F.  R.  C.  S.  E Assistant  Sm-geon 

W.  F.  Martin,  M.  D. Intemal  Medicine 

M.  A.  Mortensen,  M.  D Intemal  Medicine 

B.  N.  Colver,  M.  D Pathologist,  Eye,  Ear,  Nose  and  Throat 

J.  T.  Case,  M.  D Roentgenologist 

A.  W.  Nelson,  M.  D Bacteriologist 

H.  S.  Kelsey,  M.  D Intemal  Medicine 

A.  J.  Read,  M.  D Electro-Therapeutics 

Paul  Roth,  M.  D Chemist,  Internal  Medicine 

S.  E.  Barnhart,  M.  D Assistant,  Internal  Medicine 

Carrie  S.  Staines,  M.  D Intemal  Medicine 

Gertrude  Johnson,  M.  D Internal  Medicine 

Laura  B.  Stoner,  M.  D Intemal  Medicine 

Bertha  E.  Moshier,  M.  D Internal  Medicine 

Maiy  V.  Diyden,  M.  D Intemal  Medicine 

Louie  E.  Vandervoort,  M.  D Obstetrician 

Clara  V.  Radabaugh,  M.  D.   . Internal  Medicine 

Mrs.  M.  S.  Foy,  R.  N Supt.  Training  School  for  Nurses 

\  Dietitian,  —   Principal  School  of 
Miss  Lenna  F.  Cooper "^  ^^^^^^^  ^^^^^  Household  Economics 

W.  W.  Hastings,  A.  M.,  Ph.  D Dean  Normal  School  of  Physical  Education 

Miss  Caroline  Zahn,  R.  N Medical  Receiving  Matron 


i.Oo 


J>f.- 


OUTDOOR    GYMNASIUM 
106 


107 


108 


THE  BATTLE  CREEK  SANITARIUM 
DIET  SYSTEM 


!j|FTER  many  years  of  patient  study  of  the  various  practieal 
questions  relating  to  dietetics,  a  plan  has  been  perfected 
whereby  foodstuffs  and  food  elements  may  be  prescribed  and 
administered  with  the  same  precision  with  which  powerful 
drugs  are  given.  The  difficulties  in  the  way  of  properly  reg- 
ulating the  dietary  of  patients  under  ordinary  circumstances 
are  practically  insurmountable.  Questions  which  the  patient  always  asks 
his  physician  are,  What  shall  I  eat,  and  How  much  shall  I  eat?  It  is 
scarcely  possible  to  ask  a  physician  two  more  troublesome  questions  than 
these  if  any  effort  is  made  to  answer  the  inquiries  intelligently. 

The  calorie  system  perfected  in  the  dietetic  department  of  the  Battle 
Creek  Sanitarium  and  the  organization  connected  with  it,  make  it  possi- 
ble to  answer  these  questions  with  the  greatest  ease,  and  ^^dth  scientific 
precision.     This  system  consists  of  the  following  elements : 

1.  A  large  variety  of  appetizing  foodstuffs  numbering  several  hundred 
dishes,  the  composition  and  caloric  value  of  each  of  which  is  accurately 
known.  The  application  of  the  caloric  method  of  estimating  food  values 
is  necessarily  the  foundation  of  scientific  dietetics.  Food  is  the  only  source 
of  energy  to  the  body.  It  is  made  up  of  various  elements  which  differ  in 
their  energy  content  and  in  their  food  value.  "When  the  composition  of  a 
food  is  known,  its  caloric  value,  that  is,  the  number  of  food  units  which  it 
contains,  may  be  easily  determined.  By  multiplying  its  percentage  values 
by  proper  fractions,  the  number  of  calories  per  ounce  of  each  food  prin- 
ciple may  be  found.  The  factor  for  proteins  and  carbohydrates  is  1.16 ; 
for  fats,  2.63.  By  the  use  of  these  factors,  it  is  easy  to  make  a  list  of 
foods  of  kno'v^Ti  energy  value  per  ounce,  provided  one  has  at  hand  a  table 
showing  the  percentage  composition  of  foodstuffs.  Extensive  tables  of  this 
sort  are  published  by  the  United  States  Government.  Bulletin  No.  28 
(Revised)  of  the  Agricultural  Department  is  particularly  valuable.  The 
data  furnished  by  this  bulletin  have  served  as  a  foundation  for  the  tables 
which  are  in  use  at  the  Battle  Creek  Sanitarium.  (For  tables  used,  see 
Appendix.)  Aid  was  also  obtained  from  the  exhaustive  works  of  Koeing  and 
Gautier.  The  large  number  of  new  foodstuffs  and  food  combinations  or 
dishes,  made  necessary  many  original  analyses  and  calorimetric  tests.  The 
results  of  calculation  have  been  verified  by  the  determinations  made  with 
the  bomb  calorimeter. 

It  is  of  primary  importance  that  the  composition  of  a  dish,  when  once 
determined,  shall  be  maintained  at  a  uniform  standard.  This  requires  con- 
stant vigilance  and  supervision,  and  the  service  of  cooks  who  have  been 
specially  trained  for  the  work,  so  that  food  shall  be  prepared  with  the  same 
degree  of  accuracy  which  the  chemist  brings  to  his  work.  Indeed,  the 
kitchen  in  such  a  scheme  as  this  must  be  organized  as  a  laboratory  and 

109 


Battle  £reek  Sanitaritntt 

Dinner 

Sunday,  April  28,  1912 


Protein       Fats       Carbo. 


E^rrREES    Protose  Fillels  -- 43. 

Nuttolene — Apple  Sauce  29- 

Rice  a  la  Carolina 13- 


46- 
56- 
63- 


Oa.   Portion 


Soups    Tomato   Bisque   14 50 11 4% 

Savory  Potato  Soup  - 11---    26- —    38-—    4% 


36 —  4        1  %..... 

40--  3     m— 

74 3        IVa— 


Vegetables    Baked  Potatoes  11 1 

Brown  Sauce  3 64- — 

Escalloped  Potatoes  - 15 45 

Creamed  Parsnips 7 16 

Fresh  Asparagus  5-—    15- 


90 

52-— 
5 — 


3 

2V4. 
4% 
3 
1 


1    - 

1%-. 


Relishes   Lettuce — Le 


1. 


Tomato  Jelly — Mayonnaise  12 6- 


Cabbage   Salad   4- 

Malt  Honey -  0-- 

Malt  Honey  with  Butter 0- 

Malt  Sugar  - 3  . 

Breads    Whole  Wheal  Bread— 1   slice 12- 

White  Bread— 1    slice  - 9- 

Entire  Graham  Bread — 1   slice 10- 

BreakfasI  Toast — 2  pieces  .-.. 4-- 

Toasted  Granose  Biscuit — two 7- 

Toasted  Rice  Biscuit — two 4- 

Bran  Biscuit — two  - 21- 

Nut    Butter    - 28- 

Dairy  Butler — 1  square 1- 


30- 

0- 

100.. 

16- 


7- 

32- 

16- 

200- 

.100- 

.   81- 


2 — 

4 

4— - 
12 

1 

0 

31 

105 

99 


61.-.. 

62 

61 

34.— 
42 — 
46— 

73 

17 

0 


31/2 
2 

2Vi 

% 

1 

1 

1 

% 

% 


% 


V2. 

2  .. 
2  . 

1  ~ 

%. 
%. 
%. 
%.. 
%. 
■%-. 
1%. 

1    . 


Cooked  Fruits   Cherry  Sauce 4 — 

Stewed  Figs  6 


6— . 


143. 


1     . 

1%. 


Beverages    Apple  Juice  - 0 0 

Graj>«  Juice  0-,. —      0^ 

Caramel  Cereal — 1   teacupful  1 I 

"  107 

0 

1  ... . 


Cream — 1    pifcherful 

Sugar — 1  sugarspoonful  O.- 
Kaffir Tea  1- 

Sanitas  Cocoa  13-- 

Hot  Malted  Nuls  - 36- 

Milfe  23. 

Yogurt  Buttermilk  28. 


67.. 

5- 


50- 
50.. 

8- 
12- 
25.. 


23- 
68- 
35.. 
42- 


3y2 
31/3 
4 

2% 
4 
4 
5 

\% 
6 
6 


¥2- 

1%. 

^.■ 

2    - 
IV*. 


Desserts    Date  Cream  Pie 42.- 

Oranges  - 4-- 

English  Walnuts   9- 


87.. 

2.. 

82. 


171. 
69. 


V2     I 


To  ascertain  the  number  of  calories  eaten  of  each  element,  add  the 
&gaxm  in  first,  second  and  third  colxmins,  opposite  the  various  articles 
eaten  and  put  down  the  sums  at  the  foot  of  the  respective  columns. 
Mark  each  article  eaten,  sign  Ijlll  of  fare,  and  hand  to  your  physician. 

A  "portion"  is  that  quantity  of  any  food  which  contains  100  calories 
or  food  ttuite.    No  food  to  be  taken  from  the  Dining-room. 


SfAME.. 


aooM.. 


110 


THE    BATTLE    CKEEK    SANITARIUM 

conducted  under  laboratory  rules  and  in  harmony  with  laboratory  prin- 
ciples. 

2.  It  is  necessary  that  the  food,  after  having  been  properly  prepared, 
shall  be  served  in  portions  of  known  values  and  weighed  with  almost  the 
same  care  with  which  the  pharmacist  dispenses  drugs.  In  no  other  way 
can  the  patient  be  assured  that  his  dietary  conforms  to  the  requirements 
of  his  prescription.  This  calorie  system,  which  was  perfected  in  this  insti- 
tution, has  now  been  in  use  since  1905.  It  is  found  indispensable  in  the 
dietetic  management  of  the  sick. 

The  accompanying  reproduction  of  a  bill  of  fare  as  actually  used  at  the 
Sanitarium  will  show  how  the  plan  above  briefly  outlined  is  carried  out. 
The  diet  tables  and  special  diet  lists  employed  in  operating  this  system  of 
dietetics  will  be  found  in  the  Appendix. 

By  this  system  it  is  quite  possible  to  regulate  the  dietary  of  every 
patient,  to  give  him  just  the  amount  of  proteins  his  case  requires,  and  with 
equal  accuracy  to  regulate  his  ration  of  fat  and  carbohydrates.  The  sys- 
tem is  indispensable  in  the  treatment  of  cases  of  obesity,  diabetes,  and  great 
emaciation. 

The  Bill  of  Fare 

The  bill  of  fare  must  be  prepared  in  such  a  way  as  to  show  for  each 
dish  just  the  number  of  calories  of  each  food  element  furnished  in  each 
portion  served,  so  that  the  patient  or  nurse  may  be  able  to  select  such 
dishes  and  such  number  of  portions  as  will  furnish  the  patient  the  total 
number  of  calories  required  by  his  prescription,  and  the  number  of  calories 
of  proteins,  carbohydrates,  and  fats  designed  by  the  physician.  The  bill 
of  fare,  properly  checked  by  the  patient  or  his  nurse,  becomes  a  record  of 
the  meal,  and  hence,  when  delivered  to  the  physician,  shows  in  just  what 
way  and  to  what  extent  the  patient  is  following  his  prescription.  It  is  be- 
lieved this  is  the  first  effort  ever  made  to  place  the  menus  or  bill  of  fare  of 
a  large  institution  upon  an  exact  and  scientific  basis  for  the  purpose  of 
controlling  nutritive  processes  in  harmony  with  the  known  principles  of 
human  metabolism.  The  practical  difficulties  to  be  overcome  were  very 
great,  but  the  results  amply  repay  the  expense  and  effort  required,  and  it 
is  hoped  that  the  methods  worked  out  may  prove  of  service  to  other  es- 
tablishments in  accomplishing  similar  purposes.  For  sample  bill  of  fare 
see  page  110. 

The  Individual  Standard  Ration 

It  is  necessary  to  have  a  standard  ration  with  which  to  compare  the 
dietary  of  each  patient.  The  dietetic  requirements  of  healthy  persons  vary 
greatly,  and  not  only  with  the  sex,  but  also  with  the  size,  and  with  the  oc- 
cupation ;  hence  a  single  standard  ration  is  not  sufficient.  It  has  been 
necessary  to  work  out  in  complete  detail  the  requirements  of  individuals  of 
different  heights.  By  the  aid  of  the  facts  developd  by  the  researches  of 
Gautier,  Rubner,  and  Benedict,  and  especially  the  comparatively  recent 
studies  or  Chittenden  and  Mendel,  it  has  been  possible    to  construct  tables 

111 


SERVING    ROOM 


CULINARY    DEPARTMENT 


l^i 


THE    BATTLE    CREEK    SANITARIUM 

which  in  practical  use  with  several  thousand  cases  have  l)cen  proved  to  be 
sufficiently  accurate  to  be  of  the  highest  service.     (See  Appendix.) 

For  example,  the  patient  who  eats  less  than  the  amount  given  in  the 
table  for  a  person  of  his  height  is  insufficiently  nourished  and  must 
necessarily  lose  flesh.  Since  from  four-fifths  to  nine-tenths  of  all  the 
food  taken  into  the  body  is  used  for  fuel,  a  person  who  is  taking  an  in- 
sufficient supply  of  food  is  necessarily  burning  up  his  own  body.  It  is  not 
an  uncommon  thing  to  find  emaciated  people  taking  less  than  half  the 
necessary  food  requirement,  and  consequently  continually  losing  in  flesh 
and  strength.  They  are  quite  unconscious  of  the  fact  that  they  are  di- 
minishing in  weight  simply  because  they  are  feeding  upon  their  own 
tissues. 

On  the  other  hand,  the  person  who  is  taking  more  than  his  normal  food 
requirement  will  probably  be  gaining  in  flesh,  though  this  is  not  invariably 
the  case.  The  surplus  is  sometimes  worked  oft'  through  the  kidneys,  bowels, 
and  other  emilnctories  at  the  expense  of  great  loss  of  energy  to  the  system. 

By  accurately  regulating  the  food  supply  according  to  the  actual  re- 
quirements of  the  individual,  any  deficiency  may  be  made  good  so  long  as 
the  nutritive  powers  are  not  completely  exhausted. 

Dosing  the  Diet 

The  proper  dosing  of  the  food  to  meet  the  needs  of  individual  cases 
is  fully  as  important  as  the  adaptation  of  drug  prescriptions  to  individual 
cases. 

The  height  being  known,  a  reference  to  the  table  at  once  shows  the 
proper  number  of  calories  of  each  sort  of  food  element  for  a  normal, 
balanced  ration.  If  the  person  is  emaciated,  from  ten  to  twenty  per  cent 
may  be  added;  if  he  is  obese,  the  amount  is  diminished  one-third  to  one- 
half  for  a  time. 

By  the  aid  of  this  system,  as  will  be  readily  seen,  the  physician  has 
such  complete  and  easy  control  of  a  patient's  dietary  that  never  for  a 
moment  need  he  be  in  the  dark  as  to  the  exact  situation,  while  he  can 
answer  easily  and  promptly  questions  which  without  the  aid  of  the  system 
outlined  are  almost,  if  not  altogether,  unanswerable. 

The  old  dietetics  was  guesswork  and  experimentation.  Sometimes  pa- 
tients were  somehow  relieved,  nobody  knew  just  how;  more  often  there 
was  no  relief,  and  even  an  aggravation  of  troubles.  There  were  no  clearly  de- 
fined principles,  no  precise  and  definite  method. 

The  new  dietetics  is  based  on  solid  facts  which  have  been  demonstrated 
by  laboratory  researches,  especially  those  of  Pawlow  and  Chittenden,  and 
which  are  accepted  as  the  latest  dictum  of  science. 

Care  is  taken  that  the  dietary  shall  not  be  monotonous.  The  importance 
of  relish  and  palatability  is  fully  recognized.  Pawlow  has  shown  the  im- 
portance of  "appetite  juice"  as  a  dominant  factor  in  digestion,  so  every 
care  is  taken  to  provide  patients  with  tasty,  well-flavored  dishes  which 
shall  furnish  nutritive  material  in  the  most  easily  digestible  form  and  in 
just  the  proportion  suited  to  each  individual  case. 

Pawlow 's  work,  with  that  of  Metchnikoff,  Tissier,  and  Combe,  has  ren- 
dered possible  the  classification  of  food  products  in  a  new  way,  and  enables 

113 


WIXTER    SOLARIUM     AXD    SUMMER    DIXIXG    ROOM 


MAIN   DINING  ROOM 
114 


THE    BATTLE    CREEK    SANITARIUM 

US  to  make  use  of  food  in  the  treatment  of  various  digestive  and  nutritive 
disorders  with  a  far  greater  degree  of  accuracy  and  efficiency  than  was  pos- 
sible a  few  years  ago. 

Scores  of  new  foods  have  been  discovered  and  developed,  which  are 
each  possessed  of  special  and  definite  therapeutic  properties,  specially  se- 
lected to  meet  certain  needs  and  conditions. 

The  hundreds  of  special  dishes  and  scores  of  special  food  preparations, 
each  of  which  has  been  carefully  studied  in  relation  to  its  nutritive  and 
therapeutic  properties,  are  classified  in  diet  lists  which  are  used  by  the 
physicians  in  arranging  the  diet  prescriptions  of  individual  patients. 
Additions  to  these  lists  are  continually  being  made  as  the  result  of  the 
Avork  of  the  experimental  kitchen,  which  is  constantly  bringing  out  tasty 
and  appetizing  combinations. 

All  these  dietetic  advantages  are  at  the  command  of  the  patient.  The 
culinary  department  of  the  institution  is,  in  fact,  simply  a  large  food  lab- 
oratory in  which  a  score  of  specially  trained  cooks  and  dietitians  cater  to 
the  dietetic  needs  and  fancies  of  a  thousand  sick  folk  daily  during  the 
busiest  months. 

Several  dietitians  are  always  in  the  dining  room  during  meals,  ready 
to  render  assistance  to  those  needing  aid.  In  special  cases,  the  bill  of  fare 
for  each  meal  is  indicated  by  a  dietitian  under  direction  of  the  physician. 

The   Diet  Kitchen 

A  special  and  well-equipped  diet  kitchen,  from  which  several  hundred 
meals  are  sent  out  daily,  is  in  commission  every  hour  of  the  day  and  night. 

Visiting  physicians  are  always  interested  in  the  "  serving-room," 
where  the  foods  are  weighed  in  portions,  to  be  transported,  steaming  hot 
and  savory,  by  the  busy  w^aiters  to  the  dining-room.  The  deftness  mth 
which  this  "apportioning"  is  done  by  the  use  of  balances  conveniently 
13laced  renders  this  an  interesting  sight. 


115 


BANQUET  IN   THE  GYMNASIUM 


DINING  ROOM    WAITERS 

116 


FOOD  SUPPLIES 


S  THE  scientific  regulation  of  the  dietary  is  one  of  the  chief 
features  of  the  Sanitarium  system,  the  matter  of  food  sup- 
plies receives  very  particular  attention. 

One  of  the  essentials  of  a  dietary  especially  designed  to 
meet  the  needs  of  invalids  is  pure  milk.  Ordinary  commercial 
milk  is  one  of  the  most  unclean  foods  that  ever  appears  upon 
the  table.  Not  infrequently  such  milk  contains  as  many  as  ten  to  twenty 
millions  of  bacteria  to  the  teaspoonf  ul.  The  ordinary  method  of  producing 
milk  affords  abundant  opportunities  for  contamination  with  stable  filth, 
dust,  fragments  of  manure,  etc.,  to  say  nothing  about  the  tubercular  and 
other  bacteria  which  may  be  derived  directly  from  the  cow. 

Pure   Milk 

The  milk  and  cream  used  by  the  Sanitarium  family  of  patients  and 
helpers  is  the  product  of  a  number  of  carefully  inspected  dairies  aggre- 
gating five  hundred  cows.  This  entire  milk  supply  is  examined  weekly 
in  the  bacteriological  and  chemical  laboratories  of  the  institution  so  as  to 
insure  the  highest  degree  of  excellence. 

The  milk  and  cream  served  upon  the  table  of  the  institution  are 
furnished  by  a  dairy  which  is  conducted  in  accordance  with  the  strictest 
rules  for  the  production  of  certified  milk.  The  cleaning  of  the  cattle  as 
well  as  the  milking  is  done  by  the  vacuum  method,  so  there  is  no  exposure 
of  the  milk  to  the  air  of  the  stable  and  no  chance  for  contamination  by 
liuman  hands.  In  addition  to  these  precautions,  the  cattle  are  examined  by 
competent  veterinary  authorities,  are  tested  for  tuberculosis,  and  are  fed 
and  cared  for  in  the  most  scrupulous  manner. 

The  Creamery 

The  creamery  in  which  this  work  is  done  is  on  the  premises  and  is 
presided  over  by  a  carefully  trained  man  who  knows  the  dangers  from 
microbes,  and  how  to  avoid  them,  and  is  under  the  supervision  of  the 
expert  bacteriologist  of  the  institution.  In  dealing  with  many  forms  of 
chronic  disease  these  sterilized  dairy  products,  especially  germless  butter 
and  cream,  are  highly  important.  Yogurt  buttermilk  and  Yogurt  cheese 
are  supplied  fresh  daily  by  the  creamery,  together  with  cottage  cheese, 
Yogurt  whey  and  other  milk  products. 

Some  twenty  years  ago  (1892)  an  attempt  was  made  to  improve  upon 
ordinary  kumiss  by  utilizing  special  lactic-acid-forming  ferments.  A 
study  of  the  observations  made  at  the  Pasteur  Institute  and  by  Professor 
Conn,  of  the  Connecticut  Agricultural  Experiment  Station,  located  at  Mid- 
dletown.  Conn.,  upon  milk  bacteria,  led  to  the  selection  of  certain  ferments 
which  produce  pure  lactic  acid,  thus  eliminating  alcohol,  the  products  of 
bacterial  action  upon  fats,   and  other  unwholesome  products  which   are 

117 


THE    BATTLE    CREEK    SANITARIUM 

found  in  kumiss,  kephir,  and  ordinary  sour  milk.  Using  these  ferments 
with  sterilized  milk,  a  product  was  ol)tained  of  superior  flavor,  the  use  of 
which  could  be  prolonged  indefinitely  without  risk  of  any  possible  in- 
jury through  absorption  of  alcohol  and  other  toxic  bodies  found  in  the 
ordinary  sour  milk  preparations.  Roger  has  recently  called  attention  to 
the  injuries  which  may  result  from  the  long-continued  use  of  kumiss  on 
account  of  the  alcohol  which  it  contains,  and  which  often  reaches  a  propor- 
tion equal  to  that  in  which  it  occurs  in  lager  beer  and  other  intoxicating 
drinks.  Eecent  discoveries  have  added  greatly  to  our  knowledge  of  fer- 
mented milk  products,  and  increased  our  appreciation  of  their  therapeutic 
value. 

The    Protective    Ferments,    Bacillus    Bulgaricus,    Bacillus    Bifidus,    and 
Glycobacter 

One  of  the  most  valuable  products  of  the  Sanitarium  creamery  is 
Yogurt,  the  Bulgarian  fermented  milk  which  has  been  studied  in  recent 
years  by  Doctor  Tissier,  of  the  Pasteur  Institute,  and  Massol,  of  Geneva,  and 
later  by  Metchnikoff.  This  milk  preparation,  known  in  Bulgaria  as  yogurt, 
in  Turkey  as  madzoon,  in  Egypt  as  leljen,  and  in  India  as  dahdi,  has  been 
known  to  Oriental  people  and  extensively  used  by  them  from  the  most 
ancient  times.  It  is  believed  by  Metchnikoff  to  be  a  prime  factor  in  the 
marvelous  longevity  of  the  Bulgarians,  who  are  longer  lived  than  any  other 
laiown  race. 

The  bacteriological  study  of  this  product  revealed  a  new  lactic-acid- 
forming  bacillus  which  has  marvelous  powers  of  acid  production  and  the 
most  remarkable  resistance.     Tissier,  of  the  Pasteur  Institute,  Paris,  and 
Distaso,  have  sho^vn  that  the  protective  flora  or  friendly  germs  which 
take  possession  of  the  small  intestine  at  birth  are  displaced  by  harmful 
bacteria  which  result  from  the  use  of  flesh  foods  and  other  germ-infected 
foodstuffs,  so  that  most  adults  among  civilized  people  have  their  intestines 
filled  with  bacteria  which  are  identical  with  those  found  in  the  intestines  of 
carnivorous  animals  and  are  carrying  on  constantly  an  active  process  of 
putrefaction.    This  condition  has  been  shown  by  Combe  and  numerous  others 
to  be  responsible  for  a  large  part  of  the  chronic  disease  from  which  civil- 
ized human  beings  suffer.     One  of  the  things  most  necessary  to  accomplish 
in  the  treatment  of  cases  of  chronic  disease  is  to  change  the  bacterial 
flora  of  the  intestine  by  the  restoration  of  the  normal  protective  bacteria. 
This  can  only  be  accomplished  by  a  most  careful  regulation  of  the  diet 
and  the  use  of  cultures  of  the  protective  organisms.     Three  important  pro- 
tective  organisms   or   so-called   beneficent  bacteria   are   now   well   known. 
First  of  these  may  be  mentioned  the  Bacillus  Bidgaricus,  discovered  by 
Massol,  scientifically  studied  by  Tissier,  and  popularized  and  exploited  by 
Metchnikoff.     This  bacillus  forms  lactic  acid  in  larger  quantity  than  any 
other  known.    It  is  not  active  to  the  human  intestine,  but  under  favorable 
conditions  can  be  made  to  grow  in  the  colon.     Soon  after  the  discovery  of 
the  Bacillus  Bidgaricus,  Doctor  Tissier,  of  the  Pasteur  Institute,  in  studying 
the  stools  of  healthy  infants,  discovered  the  Bacillus  hifidus,  a  protective 
■organism  which  takes  possession  of  the  intestine  of  the  infant  within  a  few 

119 


THE    BATTLE    CREEK    Sz\NITARIUM 

hours  after  birth.  This  bacillus  grows  in  the  large  intestine  and  produces 
acetic  acid.  It  belongs  to  the  normal  flora  of  the  alimentary  canal,  but  by 
an  unwholesome  diet  is-  largely  displaced  by  the  colon  bacillus  and  putre- 
factive bacteria.  Tissier  reports  the  cure  of  thousands  of  persons  suffering 
from  intestinal  disorders  by  administering  daily  cultures  of  this  bacillus. 
Through  the  courtesy  of  Doctor  Tissier,  consulting  bacteriologist  of  the 
Battle  Creek  Sanitarium,  we  have  received  supplies  of  these  cultures  from 
the  Pasteur  Institute. 

Metchnikoff,  of  the  Pasteur  Institute,  has  recently  amiounced  the  dis- 
covery by  himself  of  a  new  protective  oi-ganism — glycobacter.  Distaso 
claims  to  have  discovered  the  same  bacillus  some  months  earlier.  This 
organism  promises  to  prove  of  great  value  in  increasing  the  activity  of  the 
Bacillus  Bulgaricus  and  the  Bacillus  hifidus.  The  last  named  germs  both 
require  sugar  to  support  their  growth  in  the  intestine.  Unfortunately,  there 
is  generally  little  or  no  sugar  in  the  colon,  as  the  sugar  is  fully  absorbed  in 
the  small  intestine.  The  Bacillus  glijcol)acter  forms  sugar  from  starch  in 
the  colon,  and  thus  is  able  to  supply  to  the  Bacillus  Bulgaricus  and  the 
Bacillus  hifidus  the  material  needed  for  their  development. 

In  the  treatment  of  cases  of  chronic  constipation,  autointoxication,  espe- 
cially in  cases  of  Bright 's  disease,  arteriosclerosis,  exophthalmic  goiter, 
cirrhosis  of  the  liver,  colitis,  gastroenteritis,  pernicious  anemia,  sprue,  and 
achylia,  these  cultures  are  used  with  very  great  advantage.  In  all  the  con- 
ditions mentioned,  and  in  most  chronic  disorders,  bacteriological  examina- 
tion of  the  feces  shows  exceedingly  bad  flora.  By  the  use  of  liquid  cultures 
of  the  protective  organisms  above  mentioned,  combined  with  an  antitoxic  or 
atoxic  dietary  and  increased  intestinal  activity,  the  flora  is  rapidly  changed. 
Welch's  Bacillus,  the  Bacillus  suhtilis,  Proteus  Bulgaris,  Bacillus  coli,  and 
the  various  classes  of  gram  positive  cocci — all  proteolytic  or  putrefactive 
poison-forming  organisms — rapidly  diminish  in  numbers  and  in  large  part 
disappear,  being  replaced  by  acid-forming  protective  bacteria,  the  normal 
flora  of  the  intestine.  With  this  change  of  the  intestinal  flora,  the  symptoms 
presented  by  the  above-mentioned  disorders  rapidly  disappear. 

Putridity  of  the  stool  often  disappears  in  a  few  days,  and  with  the 
putridity  disappear  the  accompanying  and  dependent  symptoms — foul 
breath,  foul  tongue,  sallow  skin,  mental  depression,  insomnia,  "bilious- 
ness," anorexia,  headaches,  and  a  host  of  aches,  ailments  and  distresses 
which  modern  physiologic  research  has  traced  to  a  common  origin  in  intes- 
tinal autointoxication. 

To  those  who  are  not  able  to  use  milk  the  ferment  is  given  in  capsules 
or  tablets  as  well  as  in  liquid  cultures,  and  in  the  form  of  yogurt  whey, 
a  by-product  of  the  manufacture  of  yogurt  cheese.  Yogurt  whey  is  one  of 
the  most  agreeable  and  certainly  is  one  of  the  most  effective  methods  of 
introducing  this  remarkable  therapeutic  ferment  into  the  alimentary  canal. 
Yogurt  whey  is  also  given  by  enema. 

Food   Specialties 

The  choicest  fruits  of  all  sorts,  fresh,  and  canned  in  glass  in  the  in- 
stitution cannery,  are  a  specialty  much  appreciated  by  the  guests.  Tens 
of  thousands  of  gallons  of  fruit  juices  and  fruits  of  various  desirable 

121 


122 


TIJE    BATTLE    CREEK    SANITARIUM 

kinds  are  put  up  in  bottles  and  jugs  in  the  suiunier  and  fall.  These  choice 
products  are  iiuidi  relied  upon  as  a  nieans  of  establishing  intestinal  asepsis 
and  thus  combating  the  autointoxication  which  is  so  often  encountered  in 
the  chronic  cases  coming  to  the  Sanitarium  for  treatment.  In  addition  to 
these  preserved  preparations,  fresh  fruit  is  supplied  in  abundance,  and 
fresh  fruit  juices  as  well  as  other  raw  fruit  and  vegetable  juices  are  pre- 
pared daily  and  served  by  special  prescription  to  those  requiring  these 
special  preparations. 

The  freshest  and  finest  of  green  vegetables  in  season,  and  bread  and 
cereals  in  unprecedented  variety  fill  out  a  bill  of  fare  ample  and  varied 
•enough  to  tempt  the  palate  of  the  most  whimsical  of  invalids. 

For  nearly  thirty  years  there  has  been  conducted  at  the  Battle  Creek 
Sanitarium  an  experimental  kitchen,  in  which  many  thousands  of  experi- 
ments have  been  made,  the  results  of  which  have  been  the  production  of 
a  new  system  of  cookery  and  a  novel  dietary  with  hundreds  of  new  dishes, 
each  of  which  has  been  carefully  prepared  with  reference  to  both  palata- 
bility  and  digestibility,  and  which  has  been  studied  calorimetrically,  so 
that  its  food  value  is  known. 

The   Original   Sanitarium   Health   Foods 

All  the  so-called  Sanitarium  health  foods  are  regularly  found  on  the 
Sanitarium  bill  of  fare,  having  been  originally  devised  solely  for  this  use. 
"The  character  of  these  foods  can  not  be  judged  by  the  numerous  imitations 
and  piracies  which  are  lauded  by  newspaper  and  signboard  advertise- 
ments in  terms  not  unlike  those  employed  by  the  patent  medicine  vendor. 

The  Battle  Creek  Sanitarium  has  no  connection  whatever  with  these 
questionable  exploitations.  The  first  thoroughly  cooked  and  dextrinized 
cereal  food  preparation  was  a  Battle  Creek  Sanitarium  product.  During 
more  than  thirty  years  experimental  work  has  been  steadily  carried  for- 
ward with  the  purpose  of  improving  the  palatability  and  digestibility  of 
man's  natural  foodstuffs.  The  first  dextrinized  cereal  was  a  granular 
product.  The  next  important  advance  was  a  toasted  flaked  cereal,  in 
which  each  grain  was  spread  out  into  a  thin  film  and  toasted  slightly 
hro^vn.  The  perfection  of  the  methods  and  machinery  for  the  production 
of  these  cereal  preparations  on  a  large  scale,  occupied  several  years.  All 
the  numerous  toasted  flaked  cereals  now  offered  in  the  market  under 
various  titles  are  made  by  the  same  methods,  used  with  varying  degrees  of 
success.  The  original  purpose  in  making  the  toasted  cereal  flake  was  to 
displace  the  half-cooked,  pasty,  dyspepsia-producing  breakfast  mush,  by  a 
thoroughly  cooked  and  easily  digestible  cereal  which  might  be  eaten  either 
dry  or  moist,  and  which  would  enter  easily  into  solution. 

That  the  eating  habits  of  the  American  public  have  been  materially 
modified  is  evinced  by  the  fact  that  thirty  to  forty  carloads  of  toasted 
flaked  cereals  are  being  eaten  daily  under  various  names  in  the  United 
States  alone,  and  the  consumption  is  steadily  increasing.  Toasted  cereal 
flakes  and  the  methods  of  making  them  are  a  Battle  Creek  Sanitarium  idea 
which  has  won  favor  throughout  the  world. 


123 


T2t 


THE    BATTLE    CREEK    SANITARIUM 

The  Farms  and   Hot-Houses 

Two  large  farms  and  several  hot-houses  supply  a  large  part  of  the 
fresh  garden  vegetables,  besides  quantities  of  peas,  tomatoes,  fruits,  and 
flowers.  The  extensive  greenhouses  maintained  by  the  institution,  compris- 
ing more  than  twelve  thousand  square  feet  of  glass-covered  beds,  supply 
the  table  with  an  abundance  of  fresh  green  vegetables,  such  as  lettuce, 
fresh  tomatoes,  and  various  relishes,  besides  a  profusion  of  flowers  in  pots 
and  vases.  The  use  of  lettuce,  celery,  and  some  other  fresh  vegetables  as 
supplied  in  market  is  always  attended,  as  JMetchnikoff  has  clearly  sho\vn, 
with  more  or  less  risk  of  parasitic  infection  because  of  the  careless  use  of 
night  soil  and  other  fertilizers  by  market  gardeners.  Such  products,  when 
not  obtained  from  the  Sanitarium  gardens  or  greenhouses,  are  always  ster- 
ilized in  the  kitchen  by  immersion  in  boiling  hot  water  before  serving. 
It  is  a  help  to  the  invalid's  appetite  to  know  that  the  table  delicacies 
placed  before  him  are  thoroughly  clean. 

The   Steward's   Record 

The  following  items  from  the  annual  report  of  the  steward  will  give 
something  of  an  idea  of  the  character  and  quantities  of  the  food  supplies 
annually  provided  to  feed  this  great  family  of  invalids  and  those  who 
care  for  them : 

Partial  List  of  the  Foods  Used  Diirins;-  1911  at  the  Battle  Creek  Sanitarium 


Apples     2,936  bn. 

Bananas    1,400  bunches 

Dates    5,950  lbs. 

Figs    13,744  lbs. 

Lemons     550  eases 

Oranges    1,650  eases 

Peaches    1,338  cases 

Pears    360  bu. 

Plums    260  cases 

Prunes    8,485  lbs. 

Tomatoes    615  bu. 

Grapes    5,500  baskets 

Grape  juice   20,000  qts. 

Apple  juice   16,528  qts. 

Canned  Pears    9,768  qts. 

Canned  peaches    7,440  qts. 

Canned  plums    1,560  qts. 


Canned    Strawbemes... 

Potatoes    

Eggs    

Nut  foods   

Miscel.  crackers    

Granola  and  Granuto.. 

Zwieback     

Cereal  coffee    

Glu.  meal  and  flour.  ... 

Beans    

Peas    

Pineapples    

Milk    

Cream    

Fresh  berries   

Rice     

Butter 


3,744  qts. 
6,500  bu. 
42,794  doz. 
1,421  eases 

5.625  lbs. 
2,786  lbs. 

17,000  lbs. 
3,579  lbs. 

1.626  lbs. 
13,640  lbs. 
12,525  lbs. 
11,366 

120,704  qts. 

37,520  qts. 

32,324  qts. 

8,730  lbs. 

56,029  lbs. 


12.") 


CLEAXIXG      COWS      BY      VAC'JUM      PROCESS 


VACUUM    MILKING    MACHINE— SANITARIUM    DAIRY 

126 


WHO   CAN    BE    HELPED    BY  THE    BATTLE 
CREEK  SANITARIUM  SYSTEM 


HYSICIANS  and  others  are  constantly  asking  such  questions  as 
these:  Can  you  cure  obesity?  What  can  you  do  for  chronic 
cardiac  cases?  What  can  be  accomplished  by  your  methods 
for  persons  suffering  with  Bright 's  disease?  What  can  be 
done  for  chronic  ovarian  disease,  intestinal  catarrh,  chloro- 
sis, pernicious  anemia,  chronic  autointoxication,  hysteria, 
hyperhydrochloria,  diabetes,  chronic  rheumatism,  arthritis  deformans, 
and  other  chronic  disorders? 

In  general  it  may  be  said  that  sufferers  from  functional  diseases  rarely 
fail  to  recover  when  willing  to  devote  a  reasonable  amount  of  time  to  the 
effort. 

In  cases  of  structural  change,  a  cure  in  the  absolute  sense  is,  of  course, 
not  possible ;  nevertheless,  so  great  improvement  may  be  secured  in  many 
cases  that  the  patient,  though  he  may  have  been  for  some  time  a  confirmed 
invalid  and  considered  incurable,  is  aMe  to  resume  the  active  duties  of  his 
business  or  profession,  to  enjoy  a  comfortable  degree  of  health,  and  to  lead 
a  reasonably  active  life. 

Of  the  many  hundreds  of  persons  who  each  year  enjoy  the  advantages 
of  the  Battle  Creek  Sanitarium  System,  nearly  all  are  greatly  benefited, 
and  by  far  the  great  majority  are  more  or  less  permanently  relieved  of 
chronic  disabling  ailments  which  are  A^dth  rare  exceptions  incurable  under 
conditions  surrounding  them  at  their  homes. 

Few  patients  visit  the  Battle  Creek  Sanitarium  who  have  not  previously 
made  use  of  all  the  remedies  in  ordinary  use  without  permanent  relief. 
The  usual  story  told  is  that  many  remedies  of  various  sorts  have  been  em- 
ployed under  the  directions  of  various  physicians,  and  that  some  degree 
of  relief  has  usually  been  experienced  as  each  new  remedy  has  been  tried, 
but  that  the  relief  was  only  temporary,  and  that  a  condition  has  finally  been 
reached  in  which  no  remedy  available  affords  appreciable  relief,  and  the 
attending  physician  has  expressed  the  opinion  that  more  thoroughgoing 
and  radical  measures  must  be  employed. 

A  case  illustrating  this  point  was  that  of  a  chronic  neurasthenic  sent 
by  a  professor  of  materia  medica  in  the  medical  department  of  a  university. 
In  his  letter  of  introduction  the  Doctor  said,  ' '  I  have  had  this  patient  under 
treatment  for  the  last  nine  years;  I  have  given  him  nearly  every  tonic  in 
the  materia  medica.  He  has  steadily  gotten  worse.  I  am  sending  him 
to  you  to  give  him  the  benefit  of  physiologic  stimulation."  Under  the 
influence  of  tonic  baths,  massage,  and  a  properly  regulated  dietary,  this 
patient  recovered  rapidly  and  was  able  to  return  to  his  business. 

Most  chronic  ailments  being  due  to  wrong  habits  or  umvholesome  con- 
ditions of  life,  no  cure  can  be  permanent  which  does  not  correct  these 

127 


A    GROUP    OF   WINTER    SCENES 

128 


THE    BATTLE    CREEK    SANITARIUM 

habits  and  conditions.     Palliative  drugs  aiford  temporary  relief,  but  they 
can  not  cure. 

A  permanent  cure  requires  a  change  in  the  patient,  a  regeneration  of 
tissue,  constitutional  reconstruction,  such  as  can  be  secured  in  no  way  other 
than  by  the  application  of  the  physiologic  method.  A  change  of  climate 
or  of  occupation  is  sometimes  temporarily  sufficient,  but  more  often  the 
patient  requires  the  advantage  of  measures  which  powerfully  influence 
metabolism,  which  encourage  hematogenesis  and  leucocytosis,  which  in- 
crease the  alkalinity  of  the  blood  and  assist  blood  movement. 

Blood-Building 

"  It  is  the  blood  that  heals ; ' '  hence  those  measures  are  the  most  effective 
in  securing  definite  and  permanent  results  which  are  capable  of  favorably 
modifying  the  quality  of  the  blood  and  its  distribution. 

Hydrotherapy  affords  a  means  by  which  the  blood-count,  leucocytosis, 
and  blood  movement,  both  general  and  local,  may  be  influenced  in  a  most 
positive  and  certain  manner.  By  it  the  local  blood  volume  in  any  bodily 
part,  internal  or  external,  may  be  increased  or  lessened  to  the  extent  of 
five  to  six  hundred  per  cent.    No  drug  can  accomplish  this. 

The  blood-count  may  be  increased  twenty-five  per  cent  or  more  by  a 
general  warm  application  followed  by  a  short  cold  spray  and  friction. 

The  white  cell  count  of  the  blood  may  be  increased  one  hundred  percent 
or  more  within  the  same  length  of  time  by  similar  measures. 

The  blood-pressure  may  be  raised  or  lowered  within  two  to  fifteen 
minutes  by  suitable  hydriatic  applications,  massage  or  other  physiologic 
means,  and  to  the  extent  of  twenty  to  sixty  millimeters  of  mercury. 

One  of  the  most  remarkable  characteristics  of  the  physiologic  method 
is  that  the  applications  may  be  repeated  as  frequently  and  as  many  times 
as  may  be  needful  or  desirable,  and  with  increasing  rather  than  lessening 
effect,  for  the  body  never  becomes  habituated  to  physiologic  applications 
as  it  does  to  the  use  of  drugs.  Indeed,  the  intensity  of  the  vital  response  in- 
creases as  the  patient  improves  in  general  vigor. 

The  measures  by  which  improvement  in  the  quantity  and  quality  of 
the  blood  is  secured  are  chiefly  the  following : 

1.  By  feeding  of  foodstuffs  which  are  rich  in  iron  and  hemagene  and 
those  salts  which  increase  blood  alkalinity.  The  great  value  which  attaches 
to  the  subtle  substances  found  in  the  juices  of  raw  fruits  and  certain  veg- 
etables is  not  overlooked. 

2.  Special  attention  is  given  to  the  improvement  of  the  digestion  by 
adaption  of  the  food  to  the  individual's  condition,  and  the  application  of 
such  measures  as  are  known  to  aid  gastric  secretion  and  motility. 

3.  The  daily  ration  is  carefully  balanced  to  the  patient's  needs,  so  that 
no  energy  shall  be  wasted  in  the  elimination  of  useless  material. 

4.  All  possible  sources  of  autointoxication  are  suppressed,  especially  in- 
testinal putrefactions.  This  is  accomplished,  not  by  drugs,  but  by  an  anti- 
toxic dietary,  and  by  various  bowel-cleansing  processes. 

5.  Hydriatic  measures  known  to  be  capable  of  powerfully  stimulating 
hematogenesis  are  systematically  employed. 

129 


GREENHCUSES 

130 


THE    BATTLE    CREEK    SANITARIUM 

6.  Application  is  made  of  such  measures  as  will  increase  the  opsonins 
of  the  blood,  an  important  index  of  blood  quality  as  well  as  one  of  the 
chief  means  of  defense. 

7.  The  increase  in  the  alkalinity  of  the  blood  is  accomplished  by  special 
regulation  of  the  dietary  with  this  end  in  view,  in  aecordanr-e  with  the  ob- 
servations of  Bunge,  Hindhede,  and  others. 

Increasing   Vital   Resistance 

Laboratory  research  and  clinical  experience  have  shown  that  vital  re- 
sistance may  be  increased — 

1.  By  the  application  of  tonic  hydriatie  measures. 

2.  By  means  of  exercise,  massage,  and  whatever  promotes  blood  move- 
ment. 

3.  By  the  improvement  of  metabolism  which  follows  suitable  applica- 
tions of  electricity  as  well  as  hydriatie  applications  and  exercise. 

4.  By  the  improved  oxidation  and  elimination  of  toxins  resulting  from 
the  breathing  of  cold  air  and  the  outdoor  life. 

5.  By  a  low-protein  dietary,  whereby  is  secured  a  very  great  reduction 
in  the  amount  of  toxic  protein  wastes  and  putrefactive  products,  thus 
clearing  out  the  tissues  and  improving  the  quality  of  the  lymph  which 
bathes  the  tissues. 

By  the  employment  of  special  food  preparations  containing  antitoxic 
ferments,  such  as  Yogurt.  Yogurt  is  also  administered  in  concentrated 
form  in  capsules. 

Limited  Use  of  Drugs 

Although  no  exclusive  system  is  acknoAvledged  or  followed,  drugs  are 
little  used,  for  the  reason  that  in  almost  every  instance  their  resources  have 
been  quite  exhausted  before  the  patient  arrives  at  the  Sanitarium;  and  for 
the  further  and  still  more  important  reason  that  little  permanent  good 
can  be  accomplished  in  the  majority  of  chronic  eases  by  any  remedy  which 
stops  short  of  thoroughgoing  body  reconstruction,  which  can  be  ac- 
complished only  by  physiologic  means. 

Few  drugs  can  be  relied  upon  to  accomplish  more  than  palliation. 
With  this  idea,  such  drugs  are  employed  as  may  render  service,  but  very 
sparingly,  indeed;  for  it  is  never  forgotten  that  drugs  do  harm  as  well  as 
good,  and  the  limited  period  of  time  which  the  patient  can  spend  at  the 
institution  makes  it  of  the  highest  importance  that  no  time  shall  be  wasted, 
and  that  a  foundation  for  permanent  health  shall  be  developed  as  rapidly 
as  possible  by  such  means  as  effect  improved  tissue  changes. 

Intestinal    Autointoxication 

First  Bouchard,  then  Roger,  Charrin,  Metchnikoff,  Tissier,  and  Combe, 
and  later  a  multitude  of  eminent  European  physicians,  recognizing  the 
presence  in  the  intestines  of  putrefactive  and  other  toxin-forming  bac- 
teria, attributed  to  the  baneful  influences  of  these  toxins  a  large  share  of 
'  the  chronic  ailments  which  appear  in  the  nosological  tables  as  distinct 

131 


ONE  OF  THE  TWO  OUTDCCR  GYMNASIUMS 

132 


THE    BATTLE    CREEK    SANITARIUM 

pathological  entities,  but  which  are  in  reality  only  the  varied  consequences 
of  one  common  condition — intestinal  autointoxication.  Of  the  one  hundred 
and  sixty  different  species  of  bacteria  which  Roger  lists  as  constituting  the 
flora  of  the  alimentary  canal,  each  one  forms  its  own  peculiar  product. 
Many  of  these  products  are  highly  toxic  and  capable  of  producing  most 
varied  and  often  destructive  effects, 

TJhe  intestinal  bacteria  are  divided  into  two  classes, — aerobes  and 
anaerobes.  Aerobes  in  general  produce  harmless  acids.  The  anaerobes 
are  pathologic  and  putrefactive  organisms  derived  in  large  part,  as  Herter 
shows,  from  meat,  hence  designated  by  him  as  "meat  bacteria."  Intes- 
tinal autointoxication  is  conclusively  shown  to  be  due  to  these  "wild" 
bacteria,  the  anaerobes,  which  have  no  useful  function  in  the  body,  and  are 
responsible,  directly  and  indirectly,  for  a  multitude  of  maladies. 

The  wide-spread  character  of  the  mischief  attributed  to  these  parasitic 
organisms  by  modern  pathology  may  be  judged  by  glancing  over  the  fol- 
lowing brief  summary  of  the  symptoms,  morbid  conditions,  and  maladies 
which  are  the  outgrowth  of  intestinal  autointoxication,  condensed  from 
Dr.  Combe's  masterly  work,  "Intestinal  Autointoxication." 

Drawn  features,  sad  expression,  skin  j'ellow  or  pale,  dryness  of  the  hair, 
ends  of  the  hair  split,  scaly  scalp,  sunken  eyes,  whites  of  the  eyes  yellow  or  dingy, 
brown  discoloration  of  the  eyelids,  cheeks,  or  other  portions  of  the  skin;  lips  red 
and  congested,  redness  increased  during  acute  attacks,  sometimes  swollen  and 
hot;  chest  emaciated,  abdomen  bulging  or  contracted;  nails  soft  and  brittle, 
transverse  notches  indicating  acute  attacks  of  toxemia ;  sometimes  white  patches 
on  the  skin  of  the  neck  or  annpits ;  glands  in  the  groin  enlarged,  movable  but 
not  sensitive;  general  perspiration  or  perspiration  of  the  hands  and  feet,  especially 
during  sleep.  Loss  of  appetite,  irregular  appetite,  abnormal  appetite,  often  dis- 
gust for  meat,  desire  for  plaster,  sand,  twine,  earth,  ravenous  appetite;  feeling 
of  tightness  at  the  waist  after  meals;  colic,  abdoinen  swollen,  veins  of  the  abdo- 
men dilated,  especially  about  the  ninth  and  tenth  ribs.  In  young  children,  liver 
often  enlarged.  Sometimes  contraction  of  the  pylorus;  often  contraction  of  the 
colon.  Attacks  of  vomiting  and  diarrhea,  bilious  attacks,  attacks  of  jaundice, 
pain  in  the  region  of  the  liver,  hardening  of  the  liver,  hemorrhoids,  abdominal 
dropsy,  gall-stones,  rapid  pulse,  symptoms  i-esembling  angina  pectoris,  pulsations 
throughout  the  body,  sensations  of  heat,  jDalpitation  of  the  heart,  abnormally  slow 
pulse,  subnormal  temperature,  sensation  of  coldness  in  the  extremities,  nosebleed, 
high  blood-pressure,  swelling  of  the  eyelids  on  awakening  in  the  morning,  swelling 
of  the  ankles,  neurasthenic  symptoms,  migraine,  sick  headache,  loss  of  memory, 
especially  for  proper  names.  Epileptoid  attacks,  tetany,  mental  disturbance,  im- 
poverished blood,  pernicious  anemia,  senility,  premature  whiteness  of  the  hair  and 
beard,  incapacity  for  muscular  exercise,  dAvarfed  growth,  nanism;  various  skin 
diseases,  especially  prurigo,  itching,  eczema,  and  other  eruptions,  urticaria,  acne, 
and  boils. 

The  essentials  of  the  plan  of  treatment  developed  and  carried  out  in  this 
institution  in  combating  autointoxication,  as  a  result  of  more  than  thirty 
years '  experience,  are  as  follows : 

1.  By  proper  feeding  to  starve  out  or  hinder  the  growth  of  the  poison- 
forming  anaerobes.  The  aerobes,  or  acid-forming  organisms,  feed  upon  car- 
bohydrates, such  as  starch,  sugar,  and  dextrins.  The  sugar  of  milk  and 
malt  sugar  are  the  best  of  all  foods  for  these  acid  formers.     On  the  other 

1,33 


THE    BATTLE    CREEK    SANITARIUM 

hand,  the  anaerobes  feed  upon  proteins.  Meat  is  the  substance  which  best 
promotes  their  growth,  because  it  not  only  supplies  the  nourishment  upon 
which  they  thrive,  but  also  introduces  into  each  morsel  swallowed  many 
millions  of  these  poison-forming  organisms  or  their  spores.  Eggs  also 
favor  their  growth,  especially  the  white  of  egg,  and  fish  and  oysters  still 
more  than  beef,  mutton,  and  flesh  of  other  warm-blooded  animals.  Care- 
fully conducted  experiments  have  shown  that  animal  fats  also  encourage 
autointoxication, — good  sterilized  butter  less  than  the  average  fats,  and 
vegetable  fats  to  a  much  less  degree.  It  is  clear,  then,  that  an  antitoxic 
diet  must  exclude  meats  of  all  sorts,  and  especially  eggs.  In  some  cases 
even  milk  must  be  discarded,  because  casein  dyspepsia  (Combe)  is  present. 

Four  grades  of  antitoxic  diet  are  employed.  One  of  the  most  effective 
means  of  combating  this  infected  condition  of  the  intestine  is  fasting ;  but 
this  is  seldom  required,  and  it  is  found  that  absolute  fasting  is  less  ef- 
fective than  a  carbohydrate  diet,  with  the  exclusion  of  proteins  and  fats 
for  a  short  period.  The  latter  plan  is  the  outgro^Ai;h  of  practical  experience, 
and  when  required,  which  is  only  in  extreme  cases,  it  works  exceedingly 
well,  clearing  the  tongue  quickly,  and  restoring  the  lost  appetite.  Proper 
bulk  is  secured  by  the  use  of  Japanese  seaweed,  a  substance  which,  while  in- 
digestible, is  unirritating  and  highly  hygroscopic,  and  not  acted  upon  by 
bacteria.  It  serves  a  most  useful  purpose  in  collecting  and  removing 
the  foreign  bacteria  which  swarm  in  the  mucus  of  the  infected  intestine. 
A  few  days  (two  to  four)  of  this  regimen  accomplish  more  in  clearing  the 
tongue  and  removing  symptoms  directly  due  to  intestinal  autointoxication 
than  two  or  three  weeks  of  fasting.  In  fasting,  the  symptoms  of  autointoxi- 
cation often  increase  because  of  the  development  of  toxin-forming  bacteria 
in  the  retained  secretions  (mucus,  bile,  and  intestinal  fluids),  which  are 
an  excellent  culture  media  for  many  anaerobes. 

After  a  few  days  of  this  regimen,  a  balanced  but  low  protein  ration 
(Antitoxic  Diet  No.  1)  is  given  the  patient,  excluding,  however,  not  only 
meat,  but  also  eggs  and  milk,  as  well  as  other  foods  (even  vegetables) 
rich  in  proteins.  Fats  are  also  taken  sparingly,  the  only  fats  allowed  being 
vegetable  fats  and  sterilized  butter  in  moderate  amount. 

After  a  week  or  ten  days  the  dietary  is  enlarged  to  include  fermented 
milk  preparations  (Antitoxic  Diet  No.  2),  and  as  the  symptoms  improve, 
fresh  vegetables,  sterilized  milk  and  cream,  and  other  foods  in  considerable 
variety  are  added  (Antitoxic  Diet  No.  3). 

The  several  graduated  dietaries  employed  will  be  found  in  the  "Battle 
Creek  Sanitarium  Diet  List,"  of  which  mention  has  already  been  made. 

Antitoxic  foods  not  only  deprive  noxious  micro-organisms  of  the  nutri- 
ment essential  to  their  growth  and  activity,  thereby  reducing  these  danger- 
ous elements  both  in  number  and  in  virulence,  but  feed  the  acid-forming 
aerobes,  promoting  their  growth  and  acidifying  the  intestinal  contents, 
and  thus  inhibiting  the  growth  and  activity  of  the  poison-forming  anaerobes. 

This  simple  means  enables  us  to  bring  into  therapeutic  operation  a 
great  biologic  principle  whereby  we  combat  deadly  pathogenic  bacteria 
with  friendly  bacteria,  and  by  thus  changing  the  flora  of  the  intestinal 
tract,  we  eliminate  a  veritable  Pandora 's  box  of  disease-producing  elements 
which  all  curative  means  heretofore  known  have  been  quite  powerless  to 
control. 

134 


THE    BATTLE    CUEEK    SANITARIUM 

2.  Of  almost  equal  rank  with  the  antitoxic  dietary  as  a  means  of  com- 
bating intestinal  infection,  are  means  for  promoting  normal  intestinal 
motility.  Stasis,  except  in  the  rectum,  greatly  favors  putrefaction  of  the 
intestinal  contents.  By  hastening  the  movement  of  decomposable  material 
along  the  intestinal  tract,  the  acid-forming  bacteria  of  the  small  intestine 
are  swept  on  into  the  colon  while  still  active,  and  the  poison-forming 
anaerobes  of  the  lower  bowel  are  discharged  from  the  body  in  copious  loose 
movements.  A  very  laxative  diet  is  required  in  many  cases.  In  some 
cases,  to  give  bulk  to  the  fecal  mass,  Japanese  seaweed  is  administered 
with  the  meals  daily  for  several  weeks  or  even  months.  The  bowels  should 
be  made  to  move  three  or  four  times  a  day. 

If  necessary,  the  enema  is  employed  as  a  supplementary  measure,— 
water,  soap  and  water,  oil,  or  all  combined  may  be  indicated.  Manual 
Swedish  movements  to  empty  the  colon  and  strengthen  the  abdominal 
muscles  are  also  employed,  and  special  colon  massage  under  the  guidance  of 
X-ray  examinations.  Galvanism  to  the  abdomen  and  the  sinusoidal  current 
to  the  rectum  and  abdomen  are  serviceable  measures,  as  are  also  various 
hydriatic  applications  which  stimulate  peristalsis  and  lessen  portal  con- 
gestion. 

3.  The  anaerobes,  which  are  the  chief  agent  of  intestinal  autointoxica- 
tion, may  be  successfully  antagonized,  as  shown  by  Metchnikoff,  Tissier, 
Combe,  and  many  others,  by  feeding  the  patient  massive  cultures  of  aerobes 
in  the  form  of  buttermilk,  kumiss,  kephir,  and  even  sour  milk.  Best  of  all 
the  fermented  milk  preparations  is  Yogurt,  a  Bulgarian  milk  preparation 
which  contains  the  most  active  and  resistant  acid-forming  bacillus  yet  dis- 
covered (Massol,  Metchnikoff).  This  preparation  is  daily  used,  in  deal- 
ing with  cases  of  this  sort,  in  quantities  of  several  hundred  pints.  A  certain 
proportion  of  patients  can  not  make  use  of  milk  in  any  form  on  account  of 
casein  dyspepsia  (Combe).  In  such  cases  the  ferment  is  given  in  con- 
centrated pure  culture,  in  tablets.  By  thus  sowing  the  intestinal  tract  with 
harmless  and  friendly  bacteria,  the  'Svild"  and  pathogenic,  poison-forming 
bacteria  are  driven  out. 

The  use  of  this  remarkable  ferment  has  been  known  in  the  Orient  for 
many  centuries.  Its  properties  have  been  studied  by  Massol,  of  Geneva, 
and  especially  by  Tissier  of  the  Pasteur  Institute,  and  it  is  now  in  great 
vogue  among  the  leading  practitioners  of  continental  JEurope,  although  as 
yet  little  known  in  this  country. 

4.  Autointoxication  is  also  combated  by  all  the  usual  tonic  means  by 
which  vital  resistance  may  be  increased, — tonic  baths,  outdoor  life,  massage, 
electricity,  and  various  other  tonic  and  restorative  measures. 

5.  These  cases  very  frequently  present  unquestionable  evidence  of  the 
existence  of  colitis,  in  the  passage  of  characteristic  shreds  and  membranes. 
Special  treatment  of  the  colon  is  often  employed  in  these  cases  and  with 
most  excellent  effect. 

No  class  of  cases  is  treated  with  more  satisfaction  than  these  cases  of 
chronic  intestinal  autointoxication.  Under  the  influence  of  the  combined 
measures  above  outlined,  improvement  quickly  appears.  The  tongue  clears, 
the  skin  loses  its  dingy  hue,  the  stool  becomes  less  putrid,  and  the  bacterial 
count  notably  less.     The  urine  contains  a  smaller  amount  of  putrefaction 

135 


OUTDOOR  GYMNASIUM 

136 


THE    BATTLE    CilEEK    SANITARIUM 

products,  a  gain  in  weight  takes  ])laee,  mikI  there  is  a  stiil  iiioi-e  mai-kt^l  gain 
in  strength.  Depression  and  various  symptoms  of  neurasthenia  disappear, 
and  the  patient  sees  himself  getting  well.  Improvement  is  often  most 
gratifying  even  when  a  pronounced  cachexia  exists  as  the  result  of  the 
chronic  intestinal  autointoxication  which  is  nearly  always  present.  Even 
in  cases  in  which  arteriosclerosis  has  developed,  or  in  which  there  is  marked 
disease  of  the  liver  and  kidneys,  great  service  may  be  rendered  the  patient 
by  the  arrest  of  the  disease  and  the  amelioration  of  his  symptoms,  even 
though  a  complete  cure  is  impossible.  The  liver  diminishes  in  size  under 
treatment,  the  albumen  disappears  from  the  urine,  the  coefficient  of  renal 
efficiency  rises,  edema  disappears,  the  patient  gains  in  flesh,  and  so  long  as 
the  prescribed  antitoxic  regimen  is  faithfully  adhered  to  this  improved 
condition  continues  for  some  time,  even  years. 

Digestive  Disorders 

By  the  aid  of  the  exact  method  of  gastric  analysis  originated  by  Hayem 
and  Winter,  the  work  of  this  department  was  many  years  ago  placed  upon 
a  sound  scientific  basis,  and  has  been  in  continued  operation  and  with  in- 
creasing success  ever  since.  The  remarkable  facts  developed  by  the  experi- 
mental work  of  Pawlow,  which  have  been  made  available  within  recent 
years,  have  rendered  possible  an  additional  and  very  great  advancement  in 
dealing  with  this  class  of  disorders. 

Visits  to  the  laboratories  of  Pawlow  and  other  eminent  European  in- 
vestigators aid  in  keeping  this  department  abreast  of  the  most  recent 
progress  in  special  lines  of  research. 

Careful  gastric  examination  is  of  course  made  in  every  case  before  a 
systematic  course  of  treatment  is  begun.  By  means  of  thoroughgoing  fecal 
examinations,  information  is  obtained  not  only  concerning  the  digestive 
work  done  by  the  stomach,  but  also  respecting  pancreatic  and  intestinal 
digestion ;  and  thus  is  obtained  a  thorough  knowledge  of  the  whole  chy- 
lopoietic  system.  The  exhaustive  examination  of  food  residues  w^hich  is 
made  in  this  laboratory  not  only  throws  light  of  the  highest  value  upon  the 
condition  of  the  digestive  process,  but  reveals  in  many  cases  the  real  cause 
of  functional  and  organic  changes  in  remote  parts  of  the  body. 

The  importance  of  thorough  mastication  is  insisted  upon.  It  is  often 
no  small  task  to  train  a  patient  out  of  wrong  habits  of  eating,  but  when  he 
sees  everybody  about  him  ''fletcherizing"  each  morsel  of  food  to  a  finish, 
he  soon  catches  the  habit. 

Many  wrong  habits  of  life  must  be  corrected.  In  the  cases  of  women 
a  reconstruction  of  the  dress  is  often  required. 

The  patient  must  be  able  to  sleep  well;  the  elements  of  worry  must  be 
eliminated  by  the  aid  of  rational  psychic  and  mental  therapeutics.  Patients 
are  taught  that,  as  Dr.  Gulick  has  so  well  said,  "Worry  is  nothing  but  a 
diluted,  dribbling  fear,  long  drawn  out."  .  "Fear-thought,"  to  use  Horace 
Fletcher's  expressive  word,  is  a  most  depressing  influence,  and  must  be 
avoided  as  a  mental  and  moral  poison.  Exact  methods  of  investigation 
render  possible  an  accurate  prognosis  in  nearly  every  case ;  so  that  those 
who  are  encouraged  to  remain  may  generally  receive  the  most  positive  as- 
surance that  good  results  will  be  realized.     The  ability  to  hold  out  deflnite 

137 


THE    BATTLE    CREEK    SANITARIUM 

and  positive  hope  of  recovery  often  accomplishes  more  for  the  patient 
than  anything  else  that  could  be  done  for  him.  It  enables  him  to  get  his 
eyes  off  the  cemetery  and  his  face  set  healthward;  and  the  quickly  de- 
veloping evidence  of  improvement,  the  detection  of  which  is  rendered  pos- 
sible by  accurate  means  of  diagnosis,  furnishes  solid  ground  on  which  to 
base  a  further  growth  of  confidence. 

A  factor  of  the  Battle  Creek  Sanitarium  System  which  is  highly  essen- 
tial in  the  successful  treatment  of  this  class  of  cases  is  the  calorimetric  sys- 
tem of  diet.    This  system  consists  of  the  following : 

1.  A  menu  consisting  of  several  hundred  dishes  having  the  qualities 
necessary  to  render  them  at  once  palatable,  digestible,  nutritive,  and 
adapted  to  the  various  maladies  and  morbid  conditions  presented  by  a 
large  and  miscellaneous  medical  clientele. 

2.  Exact  knowledge  respecting  the  caloric  value  of  each  of  these  arti- 
cles, and  of  the  several  food  principles  contained  in  each.  The  building  up 
of  such  a  menu  is  no  small  task.  The  recipe  or  formula  of  each  dish 
must  be  worked  over  in  a  laboratory  kitchen  by  experts  until  perfect  as  it  is 
possible  to  make  it.  Then  the  calory  estimations  must  be  made  by  the 
bomb  calorimeter,  combined  with  the  usual  methods  of  food  analysis.  In 
the  beginning,  this  work  was  much  facilitated  by  the  very  exact  study  of 
raw  and  cooked  foods  made  by  the  U.  S.  Department  of  Agriculture.  The 
use  of  standard  tables,  however,  is  necessarily  a  more  or  less  inaccurate 
method,  and  it  was  soon  found  necessary  to  carefully  revise  and  check  the 
estimations  of  values  by  means  of  the  bomb  calorimeter  and  original  an- 
alyses. Foodstuffs  are  constantly  fluctuating  in  nutritive  value  and  com- 
position, so  it  is  necessary  to  employ  one  or  more  experts  in  chemical 
work  to  maintain  a  sufficiently  approximate  degree  of  exactness  to  give  sat- 
isfactory results. 

3.  The  menu  is  now  ready  for  use ;  but  its  value  depends  wholly  upon 
scientific  accuracy  on  the  part  of  the  cooks.  Each  formula  must  be  com- 
pounded with  the  exactness  of  a  pharmaceutical  prescription.  The  kitchen 
must  become  a  chemical  and  physical  laboratory.  The  cooks  must  be 
experts  in  the  culinary  art  and  conscientious  so  that  they  can  be  relied 
upon  to  the  last  degree.  The  chef  must  be  a  man  of  unusual  intelligence, 
large  and  varied  experience,  thoroughly  faithful,  loyal,  and  conscientious, 
and  besides  this,  he  must  have  had  special  laboratory  training  such  as 
cooks  and  chefs  usually  know  nothing  about,  and  generally  would  be 
quite  unable  to  receive,  because  of  insufficient  education. 

Over  all  must  be  a  dietitian  who  has  probed  deep  into  the  science  of 
nutrition  and  the  chemistry  and  physics  of  foods  and  food  preparations. 

4.  "With  all  these  requisites,  scientific  food  may  be  scientifically  pre- 
pared. The  next  thing  is  the  apportioning  and  serving.  In  the  prepara- 
tion, the  nicest  care  has  been  taken  to  make  each  dish  of  standard  quality 
and  nutritive  content;  all  this  painstaking  effort  will  be  lost,  however, 
unless  the  apportioning  is  done  with  such  mathematical  accuracy  in  meas- 
uring and  weighing  that  each  patient  served  will  get  the  exact  amount 
for  which  his  prescription  calls.  In  no  other  way  is  it  possible  to  regulate 
the  diet  quantitatively.  Accuracy  in  apportioning  is  secured  by  means  of 
eonveniently  arranged  balances  and  specially  made  measuring  cups  and 

138 


THE    BATTLE    CREEK    SANITAKUM 

dippers.     Intelligent  aiui  wuii-trained  persons  are  employed  i'or  this  woi'k. 
and  a  physician  is  detailed  to  watch  the  serving  during  meal  hours. 

5.  The  next  problem  is  the  construction  of  the  daily  bill  of  fare.  A 
monotonous  or  too  much  restricted  dietary  is  not  conducive  to  the  pro- 
duction of  "appetite  juice."  The  menu  must  be  varied  and  the  patient 
must  have  the  liberty  of  choice.  This  is  accomplished  by  prescribing  for 
the  patient  under  the  number  of  calories  or  food  nuits  in  total,  or  for  each 
food  principle,  as  the  case  may  recpire. 

For  example,  a  patient  who  requires  2,000  calories  per  diem  will  be  in- 
structed to  take  200  calories  of  protein,  600  calories  of  fat,  and  1,200 
calories  of  carbohydrates,  rather  than  a  prescription  respecting  the  ex- 
act amount  of  bread,  rice,  butter,  or  other  foods  that  he  should  eat. 

The  patient,  of  course,  receives  general  instruction  respecting  the 
foods  that  are  specially  indicated  in  his  case,  and  those  which  should  be 
avoided,  as  may  be  necessary ;  but  he  is  thus  allowed  m  uch  latitude  in  the 
arrangement  of  each  individual  meal,  and  so  does  not  feel  restricted.  The 
menu  is  conveniently  arranged  so  that  the  patient  may  check  each  article 
ordered  or  eaten,  and  at  the  beginning  or  close  of  the  meal  he  simply  adds 
up  the  figures  opposite  the  articles  checked,  and  the  total  is  the  number  of 
calories  eaten. 

Patients  are  often  surprised  to  find  themselves  taking  only  half  the 
amount  absolutely  needed  for  maintenance,  and  they  see  at  once  the  reason 
why  they  are  losing  flesh.  They  also  see  at  once  the  only  way  in  which 
the  loss  can  be  made  good,  and  their  cooperation  is  thus  secured. 

A  medical  dietitian  is  always  at  hand  to  give  advice  and  assistance 
to  newcomers  as  may  be  needed ;  but  the  first  three  days  at  the  diet  table 
during  the  research  period  is  usually  sufficient  to  initiate  the  patient  into 
the  mysteries  of  the  bill  of  fare  and  to  get  him  started  in  the  scientific 
study  of  his  nutrition. 

6.  The  marked  menu  is  a  record  of  the  patient's  meal,  which  may  be 
filed  for  future  reference.  The  patient  records  the  caloric  totals  on  the 
blank  in  his  prescription  book  provided  for  the  purpose.  This  he  shows  to 
his  physician,  who  is  thus  enabled  to  keep  close  track  of  his  dietetic  con- 
ditions. 

Experience  during  more  than  five  years  has  sho^^na  that  it  is  possible 
to  feed  a  thousand  persons  three  times  a  day  from  a  single  kitchen,  and 
to  know  to  a  very  close  approximation  the  number  of  food  units  con- 
sumed by  each. 

This  is  the  Battle  Creek  Sanitarium  calorimetric  system  in  a  nutshell. 
The  diet  tables  employed  and  extended  dietaries,  together  with  tables  pre- 
pared from  the  U.  S.  Grovernment  tables  of  food  analyses,  are  published  in 
the  "Battle  Creek  Sanitarium  Diet  List,"  and  will  be  found  in  the  Ap- 
pendix. By  the  aid  of  this  system,  the  physician  may  Imow  at  a  glance 
whether  his  patient  is  taking  a  high  or  low  protein  diet,  too  much  or  too 
little  fat,  and  whether  or  not  he  is  following  his  prescription. 

The  dry,  bloodless  skin  of  the  dyspeptic  must  be  made  active  and  vas- 
cular, thus  relieving  the  congested  stomach  and  liver.  The  prolapsed 
stomach  and  other  viscera  must  be  replaced  and  retained  in  position  by 
suitable  abdominal  supporters  and  by  strengthening  the  abdominal  mus- 

139 


AN  AFTERNOON  ON  THE  LAT\'N 


THE    CHAPEL 
140 


THE    BATTLE    CREEK    SANITARIUM 

cles  by  massage,  special  exercises,  "movements,"  and  the  sinusoidal  cur- 
rent. Irritated  sympathetic  ganglia  must  be  relieved  by  suitable  appli- 
cations to  the  abdomen.  Derivative  and  tonic  applications  of  various  sorts 
must  be  made. 

All  measures  for  improving  the  general  bodily  health  which  are  ap- 
plicable to  the  case  in  hand  must  be  employed,  for  we  must  rely  upon  the 
body  itself  for  actual  cure  of  the  digestive  disorder. 

Specific  disorders  of  the  nutritive  tract  require  the  application  of 
specific  means.  Those  employed  in  some  of  the  more  common  conditions 
will  be  briefly  described. 

Hyperhydrochloria   or  Acid    Dyspepsia 

This  condition,  formerly  too  often  attributed  to  fermentation  in  the 
stomach,  is,  in  fact,  rarely  accompanied  by  fermentation.  It  is  the  result, 
as  is  now  well  known,  of  an  excessive  formation  of  acid.  The  following  are 
the  essential  features  of  the  method  employed  in  dealing  with  this  con- 
dition : 

1.  A  dietary  which  Avill  suppress  the  formation  of  hydrochloric  acid 
and  encourage  the  development  of  pepsin  so  as  to  increase  the  utilization 
of  the  acid  formed.  This  is  accomplished  by  the  employment  of  well- 
dextrinized  cereals.  Foods  predigested  with  diastase  are  found  useful  in 
some  cases. 

All  food  should  be  taken  in  the  form  of  a  thick  puree  which  can  be 
swallowed  without  chewing.  It  should  be  chewed  very  little  or  none  at 
all.  The  purpose  is  to  introduce  the  food  into  the  stomach  in  such  a 
manner  that  it  can  easily  pass  on  into  the  intestines  and  so  avoid  the  stim- 
ulation of  the  stomach  which  naturally  results  from  the  presence  of  food. 
The  patient  is  cautioned  to  avoid  chewing  or  fletcherizing,  as  this  produces 
appetite  juice  and  encourages  excessive  gastric  acidity. 

It  is  noticeable  in  most  of  these  cases  that  the  bowels  are  very  inactive, 
hence  the  importance  of  calling  special  attention  to  securing  proper  ac- 
tivity of  the  intestine.  Among  primitive  people  much  attention  is  generally 
given  to  the  care  of  the  bowels,  which  move  three  or  four  times  a  day,  or 
after  each  meal. 

Butter  made  from  cream  which  has  been  thoroughly  sterilized  is  tol- 
erated by  most  patients,  although  Combe  and  other  investigators  have 
shown  that  vegetable  fats  are  more  easily  digested  and  assimilated  than 
animal  fats,  and  are  less  likely  to  encourage  intestinal  autointoxication, 
which  is  often  present  in  these  cases.  The  butter  used  on  the  Sanitarium 
table  is  prepared  fresh  daily  in  the  Sanitarium  creamery  from  cream  re- 
moved from  fresh  milk  by  a  centrifugal  separator,  then  sterilized,  cooled, 
and  churned  thoroughly,  and  washed.  Such  care  is  taken  in  the  prepara- 
tion of  this  butter  that  it  may  be  kept  perfectly  sweet  for  months  without 
ice. 

Fresh,  pure  olive  oil  and  nut  oils  are  found  very  acceptable  to  many 
patients,  agreeing  better  even  than  sterilized  butter.  Certain  nuts  and 
nut  preparations  are  also  found  of  service,  especially  almonds,  pecans, 
Turkish  hazelnuts,  hickory  nuts,  and  fresh  walnuts. 

141 


THE    BATTLE    CREEK    SANITARIUM 

Id  cases  in  which  the  amount  of  acid  is  very  great,  foods  rich  in  both 
proteins  and  fats  are  employed  for  a  short  time,  being  generally  given  in  the 
form  of  purees.  Sterilized  cream  gluten  gruel  and  malted  nuts  are  found 
to  be  particularly  useful  for  this  purpose.  The  vegetable  fat  suppresses 
HCl  secretion,  the  excess  of  protein  absorbs  and  neutralizes  the  gastric 
acid  set  free,  while  the  licjuid  form  reduces  to  a  minimum  the  length  of 
time  the  food  remains  in  the  stomach,  thus  giving  the  irritable  membrane 
a  therapeutic  rest.  This  end  is  still  further  met  in  extreme  cases  by  giving 
the  food  in  frozen  form. 

Tea,  coffee,  condiments,  pickles,  and  in  some  cases,  for  a  time,  even  acid 
fruits,  are  suppressed.  Meats  of  all  sorts,  bouillon,  and  meat  extracts  of 
every  description  are  carefully  eliminated,  for  the  reason  that  they  power- 
fully excite  acid  formation,  as  sho\vn  by  Pawlow, — an  observation  which 
has  been  confirmed  by  other  laboratory  investigators  as  well  as  by  clinical 
experience.  Sodium  chlorid  is  restricted,  and  in  severe  cases  a  dechlori- 
nated  diet  is  employed  for  a  time. 

The  patient  is  required  to  rest  one  hour  after  each  meal,  avoiding  sleep. 

The  scientific  arrangement  of  the  diet  system  previously  described  is  of 
great  service  in  these  cases.  It  enables  the  patient  as  well  as  the  physician 
or  nurse  to  see  at  a  glance  which  articles  on  the  bill  of  fare  contain  the 
food  principles  required  by  his  condition,  thus  giving  the  patient  all  the 
latitude  possible  in  selection,  while  still  keeping  in  line  with  his  pre- 
scription. 

2.  The  patient  is  advised  to  drink  hot  water  an  hour  before  meals  and 
about  two  hours  after  meals,  but  to  avoid  much  fluid  at  meal-time. 

3.  Hot  applications  are  made  over  the  stomach  and  spine  opposite  for 
relief  of  pain.  The  moist  girdle,  combined  with  a  very  hot  application  over 
the  stomach,  renders  valuable  service  when  vomiting  and  gas  formation 
are  prominent  symptoms.  The  electric-light  bath  or  some  other  form  of 
vigorous  sweating  bath,  applied  two  hours  before  dinner,  lessens  the  for- 
mation of  acid.  The  visceral  congestion  which  leads  to  excessive  secretion 
is  also  diminished  by  massage  and  muscular  exercise.  General  cold  appli- 
cations are  employed  cautiously,  as  they  stimulate  acid  formation.  Cold 
applications  are  of  very  short  duration,  care  being  taken  to  secure 
thorough  reaction  immediately  following  the  bath. 

A  preparation  of  gluten,  with  which  is  combined  a  definite  proportion 
of  protein,  is  recommended  as  a  means  of  neutralizing  the  excessive  acid 
in  these  cases.  The  acid  combines  with  the  gluten  and  thus  becomes  in- 
capable of  attacking  the  gastric  mucous  membrane,  which  is  the  cause  of 
pain  and  ulceration. 

The  most  extreme  cases  of  hyperhydrochloria  are  found  to  yield  to  the 
thorough  application  of  these  measures. 

Hypohydrochloria 

Most  of  the  indications  are  essentially  the  opposite  of  those  of  hyper- 
hydrochloria. 

Highly  peptogenic  foods  must  be  employed.  The  foods  must  be  well 
relished,  but  condiments  render  no  service,  as  hypohydrochloria  is  one  of 

142 


THE    Bx\TTLE    CREEK    SANITARIUM 

the  conditions  resulting  from  excessive  stimulation.  The  stomach  is  worn 
out  and  must  be  given  as  easy  a  time  as  possible,  and  its  energies  must  be 
reinforced  by  natural  agencies,  but  not  by  artificial  stimulation.  The 
experimental  kitchen  and  food  laboratories  of  the  institution,  which  have 
been  in  operation  for  more  than  twenty  years,  are  continually  turning  out 
new  and  tasty  dishes  and  food  products  in  which  appetizing  qualities  are 
produced  by  developing  natural  peptogenic  and  gustatory  properties.  These 
are  the  most  powerful  of  peptic  stimulants,  and  produce  no  ill  effects,  as 
do  artificial  stimulants,  such  as  condiments.  The  motility  is  generally  low, 
hence  the  greatest  care  must  be  taken. in  the  thorough  mastication  of  food. 

As  constipation  is  commonly  present,  peristalsis  is  promoted  by  the 
free  use  of  syrupy  malt  preparations  and  other  laxative  foods.  Malt  ex- 
tracts are  also  beneficial  by  their  peptogenic  properties. 

Prolonged  and  thorough  mastication  of  appetizing  foods  develops 
appetite  juice,  which  Pawlow  has  shown  to  be  the  most  important  element 
of  the  gastric  juice. 

The  ice-bag  is  applied  to  the  epigastrium  for  a  few  minutes  half  an 
hour  before  meals  to  stimulate  the  solar  plexus  and  thus  increase  appetite 
and  secretion.  Half  a  glassful  of  cold  water  an  hour  before  eating  is 
generally  useful  for  the  same  purpose.  Appetite  generally  develops 
quickly  as  the  result  of  the  increased  rate  of  movement  of  the  intestinal 
contents  and  improved  assimilation. 

Appetite,  secretion,  and  motility  are  encouraged  by  short,  cold  baths, 
beginning  with  cold  frictions  and  carefully  increasing  the  vigor  of  the 
treatment  as  the  patient  acquires  ability  to  react  and  thus  to  enjoy  the 
application. 

Massage  of  the  stomach,  both  manual  and  mechanical,  massive  vibra- 
tion, the  application  of  the  sinusoidal  electrical  current  to  the  abdomen 
and  sometimes  to  the  interior  of  the  stomach,  the  moist  abdominal  band- 
age applied  at  night  over  the  stomach,  the  abdominal  supporter  when  the 
stomach  is  prolapsed,  phototherapy,  the  outdoor  life,  sleeping  in  cool, 
fresh  air, — these  are  all  effective  methods  which,  when  applied  simultane- 
ously, rarely  fail  to  effect  definite  and  most  gratifying  results. 

In  many  of  these  cases,  the  stomach  never  recovers  its  ability  to  pro- 
duce gastric  juice  in  normal  quantities,  although  a  few  recoveries  have  been 
observed  under  treatment. 

The  attempt  was  formerly  made  to  treat  these  cases  by  administering 
hydrochloric  acid  in  solution,  but  this  plan  was  soon  found  to  be  impracti- 
cable, because  it  was  necessary  to  dilute  the  hydrochloric  acid  to  such  a 
degree  as  to  render  it  of  little  value  to  the  stomach.  Even  then  there  was 
considerable  danger  of  damage  to  the  teeth  and  other  sensitive  parts. 
To  obviate  this  difficulty  a  special  preparation  of  vegetable  protein  is  pro- 
vided which  holds  a  considerable  cjuantity  of  hydrochloric  acid  in  a  loose 
combination  that  is  readily  broken  up  by  the  stomach.  Hydrochloric 
acid  taken  in  this  way  produces  no  harmful  effects  and  enables  the  stomach 
to  do  its  normal  work  in  digesting  the  food  and  passing  it  along  to  the 
small  intestine.  By  this  means  as  much  hydrochloric  acid  as  is  needed 
in  the  stomach  can  be  supplied  even  in  cases  in  which  the  stomach  is  un- 
able to  make  any  acid  whatever. 

143 


VIEWS    ABOUT    THE    LAWNS 

144 


THE    BATTLE    CREEK    SANITARIUM 

The  value  of  this  acid  protein  is  appreciated  wheu  it  is  remembered 
that  the  gastric  juice  not  only  aids  in  the  digestion  of  proteins  in  connection 
with  pepsin,  but  also  disinfects  the  gastric  contents,  regulates  the  movements 
of  the  pylorus,  stimulates  the  influence  of  the  bile  and  the  pancreatic  juice, 
and  activates  the  intestinal  ferments. 

Apepsia — Achylia 

When  the  gastric  function  is  wholly  suspended,  the  glands  no  longer 
secreting  either  pepsin  or  hydrochloric  acid,  it  can  hardly  be  expected  that 
there  will  be  a  restoration  of  normal  function.  The  problem  to  be  solved 
in  such  a  case  is  how  to  enable  the  patient  to  tolerate  his  crippled  stomach; 
rather,  how  to  get  along  without  his  stomach ;  to  be  well  in  spite  of  its  in- 
activity. 

In  most  cases  this  is  possible.  The  diet  must  be  confined  to  such 
foods  as  do  not  require  gastric  activity;  hence  flesh  foods  must  be  wholly 
proscribed.  Fats,  and  especially  animal  fats,  must  be  used  very  sparingly 
and  in  a  state  of  emulsion,  for  Cannon  has  shown  that  fats  remain  longer  in 
the  stomach  than  any  other  food  element ;  it  is  known  also  that  fat  lessens 
Ihe  secretion  of  gastric  acid  (Pawlow),  and  hinders  the  action  of  the  saliva 
and  gastric  juice  upon  the  foodstuffs.  Salivary  digestion  proceeds  well  in 
the  apeptic  stomach. 

In  cases  in  which  the  bacteriological  examination  of  the  stomach  fluid 
shows  great  infection,  it  is  sometimes  found  best  to  confine  the  patient's 
diet  to  yogurt  buttermilk  almost  exclusively  for  a  time.  Remarkably 
satisfactory  results  are  often  obtained  by  this  plan  of  feeding  in  con- 
junction with  measures  for  building  up  the  general  vital  resistance.  For 
instance,  in  a  case  under  treatment,  in  which  twenty-five  million  germs 
were  found  in  each  cubic  centimeter  of  the  stomach  fluid,  the  bacteria 
wholly  disappeared  under  a  sterile  and  antitoxic  diet. 

The  patient  is  required  to  follow  permanently  a  strictly  antitoxic  diet. 

The  success  attained  in  the  treatment  of  these  cases  is  most  gratifying. 
The  patient  may  be  assured  of  a  practical  cure  if  willing  to  follow  in- 
structions carefully  and  perseveringly.  In  not  a  small  proportion  of  cases 
the  evidences  of  chronic  inflammation,  mucus,  membranes,  shreds,  etc.,  dis- 
appear in  a  few  weeks,  a  gain  in  weight  begins,  the  blood  and  general  ap- 
pearance improve,  the  bacterial  count  lessens,  the  proportion  of  anaerobes 
in  the  intestinal  flora  is  sIioa^ti  by  the  gram  stain  to  markedly  diminish, 
and  the  patient  finds  ample  ground  for  encouragement  that  he  is  on  the 
right  road  to  recovery. 

There  are,  of  course,  cases  of  anhydrochloria  for  which  nothing  can  be 
done.  When  the  gastric  mucous  membrane  has  undergone  complete 
atrophy  and  chronic  intestinal  autointoxication  has  continued  its  ravages 
for  so  long  a  time  that  the  liver,  spleen,  kidneys,  and  other  vital  organs 
have  been  extensively  damaged,  little  more  can  be  done  than  to  lessen  the 
patient's  discomfort  by  exact  adaptation  of  foods  to  his  crippled  digestive 
organs,  and  by  the  employment  of  such  sustaining  treatment  as  he  is  able 
to  receive.  Anhydrochloria  due  to  malignant  disease  of  the  stomach  is 
also  an  incurable  condition,  but  much  can  be  done  to  relieve  the  sufferings 

145 


146 


THE    BATTLE    CREEK    SANITARIUM 

of  these  patients,  when  the  disease  has  advanced  so  far  as  to  render 'op- 
eration inadvisable,  by  the  employment  of  a  bland  and  strictly  antitoxic 
dietary. 

Disease   of   Gall-Ducts  and   Gall-Bladder 

Infectious  jaundice  or  inflammation  of  the  biliary  passages  accompanies 
intestinal  autointoxication,  and  is  a  result  of  an  extension  of  the  anaerobic 
infection  of  the  intestine  to  the  liver  through  the  portal  vein  and  biliary 
passages. 

Attention  is  especially  given  to  the  gastric  and  intestinal  catarrh 
with  which  the  disease  is  usually  associated. 

Thorough  antitoxic  treatment  is  found  effective  in  these  cases.  The 
diet  and  general  methods  used  in  intestinal  autointoxication  are  found 
rapidly  effective  in  these  cases,  and  have  effected  permanent  cures  in  nu- 
merous cases  which  had  been  regarded  as  proper  subjects  for  surgical 
operation. 

The  sweating  electric-light  bath  and  the  prolonged  neutral  bath  relieve 
itching ;  so  does  sponging  with  very  hot  solutions  of  common  salt  or  soda. 
Water  drinking  to  the  extent  of  three  to  five  pints  daily  and  abdominal 
massage  are  indicated.  Gallstones,  if  present,  are  sometimes  dislocated  and 
discharged.^  The  chief  measures  employed  are  the  electric-light  bath, 
neutral  saline  bath,  and  very  hot  saline  sponging  to  relieve  itching;  arc 
light  to  the  trunk,  fomentations,  thermophore,  photophore,  or  other  ther- 
mal applications  over  the  liver  and  abdomen  two  or  three  times  daily,  fol- 
lowed by  heating  compress  during  interval  to  relieve  pain,  encourage 
leucocytosis,  and  improve  the  circulation  of  the  splanchnic  area;  the 
enema  at  90°  to  75°  once  or  twice  daily,  to  aid  intestinal  antisepsis  and 
to  promote  hepatic  activity;  strict  antitoxic  diet;  tonic  hydriatic  measures 
to  promote  general  vital  resistance. 

Simple  infectious  jaundice  is  always  curable.  If  there  is  obstruction 
due  to  gall-stones,  operation  is,  of  course,  required  in  addition  to  the  treat- 
ment. The  operation  is  much  more  likely  to  be  successful  if  preceded  by 
treatment  to  remove  febrile  condition  and  correct  the  intestinal  autointoxi- 
cation. 

After  operation  it  is  highly  important  that  the  patient  should  be  sub- 
jected to  a  thorough  course  of  treatment  to  remove  the  causes  which  have 
given  rise  to  the  formation  of  biliary  calculi,  so  that  the  diseased  condition 
shall  not  return. 

The  fact  that  ten  per  cent,  possibly  more,  of  adults  past  middle  age 
are  carrying  about  stones  in  their  gall-bladders  without  being  in  any  way 
conscious  of  the  fact,  is  evidence  that  the  mere  presence  of  gall-stones  is 
not  an  indication  for  surgical  operation.  The  disease  often  becomes  qui- 
escent and  so  remains  indefinitely  when  the  intestinal  infection  is  overcome. 

Eecent  investigations  have  shown  that  when  gall-stones  are  formed 
in  the  gall  bladder  they  are  the  result  of  infection,  the  original  source  of  the 
invading  bacteria  being  usually  the  intestine;  hence  in  these  cases  it  is 
highly  important  to  give  attention  to  intestinal  asepsis.  The  patient  is 
placed  upon  a  thoroughly  atoxic  or  antitoxic  dietary.     Cultures  of  protec- 

147 


THE    BATTLE    CREEK    SANITARIUM 

tive  microbes  are  employed,  and  peristaltic  activity  is  stimulated  by  all 
rational  means.  Laxative  drugs  must  be  dispensed  with,  however,  as  these 
lower  the  resistance  of  the  intestinal  mucous  membrane  and  so  ultimately 
aggravate  the  morbid  condition  present,  no  matter  how  great  may  be  the 
temporary  relief  afforded  by  their  use.  By  means  of  laxative  foods,  the 
basis  of  which  is  a  diet  containing  not  less  than  400  grains  of  cellulose 
daily,  and  by  the  use  of  such  other  known  medicinal  measures  as  the  use 
of  Ceylon  moss,  a  hemi-cellulose,  paraffin  emulsion,  colon  massage,  the 
cool  enema,  application  of  electricitj^  to  the  abdomen  and  colon,  hydriatic 
measures  of  various  sorts,  mechanotherapy,  and  special  exercises  for  the 
development  of  the  abdominal  muscles,  the  bowels  are  made  to  move  three 
or  four  times  a  day. 

Constipation 

The  great  majority  of  cases  fall  into  one  of  four  classes : 

(a)  Cases  of  constipation  from  atony  or  from  dilation  of  the  colon — 
a  very  common  form — receive  short  cold  applications  externally,  cool 
enemas,  abdominal  massage,  colon  massage,  manual  movements,  and  lax- 
ative diet,  which  includes  vegetable  fats,  acid  fruits,  fruit  juices,  and 
various  laxative  preparations  of  Japanese  seaweed  and  other  special 
products. 

The  tone  of  the  abdominal  muscles  is  improved  by  massage,  electricity, 
cold  applications,  sprays,  and  douches,  short  tonic  sitz  bath,  the  plunge 
bath,  and  especially  swimming,  gymnastic  exercises,  manual  and  mechani- 
cal Swedish  movements.  Enemas — oil,  soap,  glycerine,  etc. — are  .sometimes 
helpful  at  the  beginning,  but  are  dispensed  with  as  soon  as  possible,  and  the 
bowel  systematically  trained  to  normal  action. 

(h)  In  some  cases  constipation  is  due  to  spasm  of  the  colon,  generally 
marked  by  a  contracted  abdomen  and  oversensitive  sympathetic  ganglia. 
The  contracted  colon  can  often  be  felt  through  the  abdominal  wall.  Spasm 
of  the  anal  muscles  from  stricture  or  rectal  irritation,  hemorrhoids,  etc., 
may  be  the  cause.  Hot  enemas,  102°  to  105° ;  hot  sitz  baths,  104°  to 
108°,  three  to  five  minutes;  warm  oil  enema  at  night;  radiant  heat  to  the 
abdomen  two  or  three  times  daily,  and  various  other  thermic  applications 
to  relieve  sympathetic  irritation  and  intestinal  spasm. 

The  oil  enema,  administered  at  a  temperature  of  104°  and  in  quantity 
of  one  to  two  or  three  pints,  is  better  suited  to  these  cases  than  the  water 
enema.  The  latter  often  increases  irritation,  as  shown  by  the  increase  in  the 
discharge  of  mucus.  These  cases  are  very  often  accompanied  by  intestinal 
autointoxication,  and  require  special  treatment  for  this  condition  in  ad- 
dition to  treatment  directly  addressed  to  relief  of  the  constipation.  The 
lack  of  gastric  acid  for  sterilizing  the  food  in  the  stomach  renders  very 
important  the  use  of  well-sterilized  foods.  G-reat  benefit  is  also  derived  in 
these  cases  from  the  use  of  the  Bulgarian  ferment,  yogurt.  It  is  highly 
important,  however,  to  avoid  habituating  the  patient  to  mechanical  empty- 
ing of  the  colon  by  means  of  the  enema.  Most  excellent  results  are  obtained 
by  the  use  of  Japanese  seaweed  administered  with  broth  three  times  a 
day.     This  preparation,  by  its  powerful  hygroscopic  properties,  prevents 

148 


THE    BATTLE    CKEEK    SANITARIUM 

excessive  dryness  of  the  fecal  matters,  while  at  the  same  time  furnishing 
bulk  for  the  intestine  to  act  upon. 

Eaw  fruit  and  vegetable  juices  are  often  found  especially  effective  in 
relieving  constipation. 

(c)   Cases  in  which  the  constipation  is  due  to  redundancy  of  the  colon. 

In  these  cases  the  colon  is  usually  both  dilated  and  prolapsed.  The 
measures  above  mentioned  for  overcoming  dilation  of  the  colon  are  used, 
together  with  special  massage  and  manipulations  for  the  replacement  of  the 
colon.  Manual  Swedish  movements  are  particularly  helpful  in  these 
cases.  A  suitable  abdominal  supporter  should  be  worn.  Careful  reg- 
ulation of  the  dietary,  especially  the  avoidance  of  large  quantities  of 
coarse,  indigestible  material  is  important  in  these  cases.  The  overstretching 
of  the  colon  is  not  infrequently  due  in  part  to  an  excessive  bulk  of  fecal 
matters. 

{d)  Cases  of  latent  constipation,  in  which,  although  there  is  a  regular 
movement  of  the  bowels  daily,  the  colon  is  never  completely  evacuated 
and  defecation  is  one  to  three  days  or  even  more  in  arrears. 

The  stasis  present  in  these  cases  encourages  the  growth  of  putrefactive 
bacteria  and  increases  their  virulence.  After  a  time,  the  bacteria  gromng 
in  the  intestinal  contents  penetrate  the  mucous  membrane,  and  chronic 
colitis  is  the  result.  These  cases  can  be  cured  only  by  change  of  the  intes- 
tinal flora  and  removal  of  all  the  causes  of  intestinal  inactivity.  The  ap- 
plication of  electricity  is  of  the  highest  service  in  many  of  these  cases  by 
restoring  the  normal  tone  of  the  intestine.  The  recent  (1911)  observations 
of  Cannon  and  Schwartz  concerning  the  normal  movements  of  the  colon 
have  thrown  valuable  light  upon  the  subject  of  constipation.  Cannon 
has  shown  that  an  atonic  or  over-stretched  atrophic  colon  is  incapable  of 
contracting.  In  order  that  the  colon  may  contract  it  must  be  in  a  "tonic" 
state.  This  condition  often  is  absent  as  a  consequence  of  infection  of  the 
intestine  by  putrefactive  organisms.  By  changing  the  flora  of  the  intes- 
tine, that  is,  by  introduction  of  cultures  of  protective  micro-organisms, 
especially  cultures  of  the  'bacillus  Infidus  as  proposed  by  Tissier,  of  the 
Pasteur  Institute,  and  by  the  proper  use  of  electricity,  the  tone  of  the 
paralyzed  colon  may  be  restored  and  thus  normal  peristaltic  movements 
may  be  recovered,  even  after  the  most  severe  constipation  has  existed  for 
many  years.  For  the  accomplishment  of  this  purpose,  electricity  is  ap- 
plied by  means  of  a  long,  specially  constructed  bi-polar  electrode  high  up  in 
the  pelvic  colon.  By  applications  of  the  sinusoidal  current,  a  tonic  con- 
dition of  the  colon  may  be  induced  and  by  its  means  normal  peristaltic 
activity  is  restored. 

Eadium,  diathermy,  and  in  certain  cases  various  forms  of  internal  ap- 
plication by  aid  of  the  rectoscope  render  valuable  service  in  special 
cases.  Every  case  of  severe  chronic  constipation  should  be  subjected  to 
thorough  examination  by  means  of  the  X-ray  and  bismuth  meal,  and 
should  also  be  subjected  to  a  rectoscopic  examination.  In  rare  instances 
surgical  means  may  be  required  to  relieve  a  "Lane's  kink,"  an  adhesion 
due  to  paracolitis  or  diverticulitis  or  some  other  organic  affection.  In 
some  cases  operation  is  required  for  the  relief  of  rectal  disease,  although 

149 


MERCURY  VAPOR  LIGHT 


VACUUM    LIGHT 
150 


THE    BATTLE    CREEK    SANITARIUM 

the  great  majority  of  cases  of  rectal  irritation,  anal  spasm,  etc.,  may  be 
relieved  by  non-surgical  measures. 

(e)  Cases  of  obstruction  due  to  stricture  and  some  other  mechanical 
causes  must  be  relieved  by  mechanical  means. 

Here  again  the  greatest  service  is  rendered  by  a  dietary  system  which 
is  capable  of  being  used  as  an  instrument  of  precision.  By  a  careful 
balancing  of  the  daily  ration  and  continuous  use  of  the  numerous  special 
laxative  foods  provided  by  the  bill  of  fare,  definite  results  are  speedily  se- 
cured. The  most  obstinate  cases  often  yield  very  speedily  to  this  combi- 
nation of  peristalsis  persuading  remedies. 

Special  movements,  so  carefully  graduated  that  they  may  be  given  to 
the  feeblest  patient,  are  of  great  service.  They  are  made  so  carefully 
progressive  that  in  a  few  weeks  the  patient  will  be  able  to  take  vigorous 
movements  without  injury  and  even  with  ease. 

In  most  cases  of  constipation  the  colon  is  the  chief  seat  of  disease. 
It  is  very  rare  indeed  that  the  constipation  depends  upon  any  diseased 
condition  of  the  small  intestine.  A  careful  study  of  the  colon  by  the 
bismuth  meal  and  by  the  introduction  of  bismuth  directly  into  the  colon 
itself  should  be  made  in  every  case  of  chronic  constipation.  A  glance  at 
the  radiographs  of  colons  shown  at  pages  153-159  will  be  sufficient  to  indicate 
the  importance  of  this  examination. 

Diseases   of  Women 

In  no  class  of  cases  is  the  physiologic  method  more  suited  and  success- 
ful than  in  the  treatment  of  the  disorders  of  women,  both  acute  and 
chronic.  The  teaching  of  Emmet  and  Peaslee  more  than  forty  years  ago 
made  known  the  great  value  of  the  hot  vaginal  douche.  In  both  acute  and 
chronic  pelvic  inflammations,  the  use  of  the  tepid  and  the  cold  douche  is 
equally  valuable  in  proper  cases. 

The  hot  sitz,  the  revulsive  sitz,  the  neutral  sitz,  and  the  prolonged  cool 
sitz,  when  properly  employed,  secure  results  which  could  hardly  be  be- 
lieved by  those  not  familiar  mth  the  hydriatic  treatment  of  this  class  of 
disorders. 

In  acute  pelvic  inflammations,  the  hot  hip  and  leg  pack,  combined  with 
the  ice-bag,  is  a  marvelously  effective  means  of  relieving  pain  and  controlling 
inflammatory  action,  whether  the  part  affected  be  an  ovary,  a  tube,  the 
uterus,  or  all  of  these  structures. 

Chronic  inflammations  and  exudates  left  behind  by  acute  inflammation 
yield  to  the  persevering  application  of  hydriatic  measures  in  combination 
with  electricity,  massage,  and  other  appropriate  means,  which  succeed  in 
a  large  number  of  cases  in  which  operative  procedures  are  often  employed. 
Pains  due  to  internal  adhesions,  the  result  of  abdominal  operations  or 
other  causes,  are  often  cured  by  the  faithful  and  persistent  use  of  suitable 
measures,  especially  thermic  and  electrical  applications. 

By  the  thorough  application  of  these  physiologic  measures,  hundreds 
of  women  have  been  saved  from  a  mutilating  surgical  operation,  and  in 
more  than  one  instance  have  become  the  happy  mothers  of  families  after 
the  removal  of  the  appendages  had  been  urgently  advised  as  necessary  to 
the  recovery  of  health. 

151 


153 


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159 


THE    BATTLE    CREEK    SANITARIUM 

Cases  of  amenorrhea  which  do  not  yield  to  the  intelligent  application 
of  the  combined  physiologic  method,  are  extremely  rare  indeed.  It  is  not 
more  difficult  to  overcome  vasomotor  spasm  and  induce  a  normal  flow 
of  vitalizing  blood  through  the  anemic,  shrunken  uterus  of  amenorrhea  than 
to  cause  reddening  of  any  portion  of  the  external  surface.  The  vaginal 
douche  (both  hot  and  cold),  the  revulsive  sitz,  the  heating  compress,  ab- 
dominal and  pelvic  massage,  the  foot  bath,  and  the  Scottish  douche,  are 
powerful  means  of  influencing  the  pelvic  circulation. 

Swimming,  an  art  little  cultivated  by  women,  is  wonderfully  helpful 
in  overcoming  the  causes  of  pelvic  disease  and  fortifying  the  patient 
against  relapse.  Feeble  patients  must,  of  course,  be  carefully  trained  in 
preparation  for  this  mode  of  exercise.  Daily  instruction  is  given  in  swim- 
ming, and  there  are  but  few  patients  who  do  not  enjoy  this  delightful 
and  healthful  exercise  after  a  week's  training  under  an  expert  teacher 
for  a  few  minutes  daily. 

Pools  of  different  temperature  are  provided,  so  that  none  are  exposed 
to  the  risk  necessarily  attendant  upon  sea  bathing,  in  which  the  temperature 
of  the  water  and  other  conditions  are  not  under  control. 

Dysmenorrhea  in  every  form  may  be  wonderfully  benefited,  and  in 
nearly  all  eases  may  be  thoroughly  cured  by  systematic  local  treatment 
combined  with  constitutional  invigoration,  relief  of  constipation,  and  im- 
proved pelvic  circulation. 

When  some  simple  preliminary  surgical  procedure  is  needed,  measures 
of  after-treatment  are  still  usually  required  to  secure  permanent  im- 
provement through  restoration  of  normal  conditions.  Surgery  alone  is  by 
no  means  uniformly  successful  in  these  cases,  as  most  surgeons  know  by 
sad  experience. 

A  careful  inquiry  will  show  that  in  a  very  large  number  of  cases  of 
chronic  invalidism  in  women,  in  which  the  therapeutic  efforts  have  been 
chiefly  directed  toward  the  pelvic  organs,  the  real  trouble  is  chronic  intes- 
tinal autointoxication,  and  complete  relief  is  obtained  only  by  antitoxic 
treatment. 

Nervous   Disorders 

"While  every  case  of  hysteria  is  not  wholly  curable,  improvement  is 
always  possible,  and  a  complete  cure  is  almost  always  attainable  by  intelli- 
gent, persevering  effort,  which  includes  thorough,  all-round  health  culture 
and  proper  psychic  management,  as  well  as  such  physical  treatment  as 
may  be  indicated.  The  physiologic  method  provides  for  every  possible 
indication  in  this  class  of  maladies. 

Various  forms  of  paralysis  yield  excellent  results  to  the  physiologic 
system  when  other  measures  fail.  In  apoplexy  due  to  degeneration  of 
the  cerebral  vessels,  the  advance  of  the  disease  may  be  stayed,  and  a  very 
great  degree  of  improvement  may  be  secured,  even  in  most  unpromising 
cases.  Even  in  cases  of  paralysis  due  to  degenerative  changes  of  the  cord, 
it  is  rare  indeed  that  the  progress  of  the  disease  may  not  be  checked  for  a 
considerable  time,  at  least,  and  in  many  instances  vast  improvement  may 
be  obtained. 

161 


162 


THE    BATTLE    CREEK    SANITARIUM 

The  measures  found  of  special  service  are  the  cold  mitten  friction,  the 
half-sheet  rub,  the  shallow  bath,  the  sinusoidal  electric  bath,  the  short  elec- 
tric-light bath  followed  by  a  cold  towel  rub  or  the  Scotch  douche,  general 
and  special  massage,  manual  and  mechanical  Swedish  movements,  the  ap- 
plication of  the  sinusoidal  current  in  such  a  way  as  to  exercise  weakened  or 
paralyzed  muscles.  Special  attention  is  given  to  the  regulation  of  the 
dietary. 

In  many  cases  there  is  high  blood-pressure,  and  often  a  more  or  less 
advanced  stage  of  arteriosclerosis.  This  especially  demands  the  suppression 
of  colon  toxins,  which  is  accomplished  by  the  enema,  disinfection  of  the 
colon,  and  an  antitoxic  dietary  to  suppress  the  development  of  bacteria 
and  bacterial  poisons,  which  doubtless  are  a  powerful  factor  in  causing  this 
diseased  condition. 

Neurasthenia 

This  so-called  malady  should  be  regarded  as  a  symptom  rather  than 
as  a  distinct  malady.  The  symptoms  to  which,  in  the  aggregate,  neuras- 
thenia is  commonly  applied  are  the  result  of  conditions  which  are  the  out- 
growth of  our  perverted  civilization.  The  cure  requires  a  return  to  nature 
in  habits  and  such  a  building  up  of  the  natural  functions  of  the  body  as 
can  be  permanently  secured  in  no  other  way  than  by  the  thoroughgoing, 
systematic  application  of  the  physiologic  method. 

The  tonic  results  afforded  by  hydrotherapy  are  the  most  effective  means 
known  of  restoring  exhausted  nerves.  There  are  no  drug  remedies  which 
compare  with  cold  baths,  which  may  be  perfectly  graduated  by  a  series  of 
systematized  procedures,  beginning  with  the  simple  application  of  cold 
water  after  a  warm  bath  (such  as  the  electric  arc  or  radiant  heat  bath) 
by  means  of  the  hand  of  the  attendant,  and  progressing  through  the  salt 
glow,  the  effervescent  salt  rub,  cold  mitten  friction,  the  effervescent  fric- 
tion, the  cold  towel  rub,  the  wet  sheet  rub,  the  dripping  sheet,  the  shallow 
bath,  the  Nauheim  bath,  the  cold  shower,  the  horizontal  jet,  and  the  cold 
plunge, — measures  gradually  increasing  in  vigor,  also  modified  in  duration 
to  suit  individual  cases. 

Massage,  manual  and  mechanical  Swedish  movements,  phototherapy, 
special  feeding,  proper  psychic  management,  and  the  outdoor  life  are 
measures  which  rarely  fail  of  success,  even  in  most  obstinate  cases. 

In  not  a  few  of  these  cases  the  real  foundation  of  the  disorder  can  be 
shown  to  be  a  chronic  toxemia,  and  the  colon  is  most  frequently  found  to  be 
the  source  of  the  poisons  with  which  the  system  is  flooded.  Bacteriological 
examination  of  the  feces  frequently  shows  in  these  cases  two  to  forty  bil- 
lion bacteria  to  the  gram  of  dried  feces,  or  one  hundred  to  one  thousand 
times  the  normal  amount.  A  nervous  system  exposed  to  the  influence  of 
such  an  enormous  amount  of  toxic  matters  must  necessarily  be  more  or  less 
deranged.  The  antitoxic  dietary  of  the  Sanitarium  is  admirably  adapted 
to  the  suppression  of  toxin  formation  in  the  alimentary  canal.  This  special 
diet  system  renders  easy  the  regulation  of  the  amount  of  proteins  and  other 
elements  with  exactitude,  and  enables  the  physician,  when  necessary,  to 
train  the  patient  down  to  a  very  low  protein  ration  without  incurring 

163 


A    CORNER  OF  THE   ROENTGEN   DEPARTMENT 
164 


THE    BATTLE    CREEK    SANITARIUM 

risk  of  injury,  since  the  isodynamie  relations  of  the  ration  may  be  kept 
always  within  safe  limits. 

Insomnia 

It  is  very  rare  indeed  that  this  sy)iiptom  does  not  speedily  yield  to  the 
soporific  influence  of  appropriate  hydriatic  measures.  The' neutral  bath 
seldom  fails  to  put  the  most  obstinate  eases  into  a  restful  state  within 
thirty  to  sixty  minutes,  and  it  is  not  an  uncommon  thing  to  see  a  patient 
fall  asleep  within  ten  or  fifteen  minutes  after  entering  the  bath.  Various 
other  procedures  are  likewise  helpful,  and  success  is  always  expected,  even 
in  the  most  stubborn  cases. 

Measures  long  employed  at  this  institution  in  dealing  with  this  class 
of  cases  have  within  the  past  few  years  been  introduced  into  several  lead- 
ing insane  asylums  in  the  country,  where  they  are  most  successfully 
employed  in  cases  of  acute  mania  with  insomnia. 

It  may  be  truthfully  said  that  insomnia  always  yields  to  the  intelligent 
application  of  the  combined  physiologic  method,  which  includes  not  only  the 
neutral  bath,  but  also  the  neutral  pack,  the  moist  girdle,  the  leg  pack,  the 
neutral  douche,  and  also  various  electrical  applications — static  and  gal- 
vanic,— massage,  and  manual  movements,  with  proper  dietetic  regulation 
and  open-air  treatment. 

In  the  great  majority  of  eases  of  insomnia,  the  real  root  of  the  trouble 
will  be  found  in  intestinal  autointoxication.  The  blood  is  filled  with  toxins, 
the  result  of  bacterial  action  in  the  intestine,  the  brain  cells  are  excited  by 
these  irritating  substances,  and  insomnia  is  the  result.  No  permanent  cure 
can  be  accomplished  in  these  cases  without  correcting  the  condition  of  the 
alimentary  canal.  The  coated  tongue  and  the  foul  breath,  which  are  nearly 
always  present  in  eases  of  chronic  insomnia,  are  an  evidence  of  this  auto- 
intoxication. The  use  of  hypnotics  increases  the  autointoxication,  and 
hence  in  the  end  aggravates  the  disease.  This  is  particularly  true  of  the 
bromids  and  allied  drugs.  A  persevering  application  of  the  Battle  Creek 
Sanitarium  system  rarely  fails  to  cure  the  worst  cases  of  insomnia. 

Radium  emanation,  diathermy  or  thermo-penetration  are  found  highly 
useful  in  many  obstinate  cases  of  insomnia.  In  nearly  all  cases  great  benefit 
is  derived  from  the  application  of  measures  to  increase  intestinal  peri- 
stalsis. When  the  patient  has  been  trained  to  secure  three  or  four  thorough 
movements  of  the  bowels  daily,  the  disturbing  toxins  are  cleared  out  of 
the  body  so  thoroughly  that  the  irritating  effects  produced  by  them  disap- 
pear. 

Locomotor  Ataxia 

This  formidable  malady,  long  considered  incurable,  yields  in  the  great 
majority  of  cases  most  surprisingly  satisfactory  results.  If  the  patient  has 
not  reached  the  very  last  stage  of  degeneration,. muscular  control  can  be 
regained  and  nearly  every  lost  muscular  movement  can  be  restored,  and  he 
can  be  made  able  to  walk  with  steadiness.  Although  the  knee-jerk  does  not 
return,  the  disappearance  of  the  ataxic  and  other  unpleasant  symptoms 

165 


166 


THE    BATTLE    CREEK    SANITARIUM 

gives  the  patient  ample  reward  for  his  effort.  In  the  treatment  of  these 
cases  it  is,  of  course,  necessary  to  take  into  consideration  the  stage  of  the 
disease  and  the  condition  of  the  patient. 

There  is  no  curative  formula  for  this  or  any  other  malady.  Each  case 
must  be  treated  on  its  own  merits.  The  chronic  autointoxication  which 
clearly  exists  in  some  cases  may  be  most  successfully  combated  by  means 
of  the  electric-light  bath,  short,  carefully  administered  tonic  hydriatie 
applications,  the  sun  bath,  the  arc  light,  and  the  actinic  ray  applied  to  the 
trunk.  The  muscular  wasting  and  general  weak-ness  may  be  ameliorated 
and  often  made  to  disappear  rapidly  under  suitable  applications  of  elec- 
tricity, especially  the  slow  alternating  sinusoidal  current,  massage,  and 
manual  Swedish  movements.  By  special  gymnastics  the  law  of  co-ordi- 
nation and  movement  is  restored,  and  gradually  the  patient  finds  himself 
returning  to  a  nearly  normal  condition,  able  to  stand  with  closed  eyes  and 
to  walk  without  staggering,  and  free  from  the  lightning  pains  which  have 
made  his  life  miserable. 

Diathermy  is  very  valuable  as  a  means  of  relieving  the  terrible  ataxic 
pains  which  often  resist  the  use  of  ordinary  remedies.  The  use  of  radium 
emanation  is  also  attended  by  a  very  considerable  degree  of  success  in 
these  cases. 

Bronchial  Catarrh 

This  obstinate  affection  usually  yields  quite  readily  to  the  Sanitarium 
system  of  management.  The  chest  pack  wonderfully  relieves  cough  and 
pulmonary  congestion,  while  tonic  applications  train  the  heart  and  skin 
to  increased  activity  and  improved  nutrition.  jMassage  improves  the  gen- 
eral circulation  and  metabolism;  suitable  applications  of  electricity  de- 
velop the  muscles  of  respiration;  phototherapy,  especially  the  actinic  ray, 
applied  to  the  chest,  relieves  local  pain  and  congestion  by  producing  a 
persistent  hyperemia  of  the  skin. 

In  many  of  these  cases  colon  infection  and  autointoxication  are  found 
to  exist.  The  improvement  of  nutrition  by  correcting  the  condition  of  the 
colon  and  the  alimentary  canal  in  general  is  not  infrequently  followed  by 
a  rapid  lessening  of  the  pulmonary  symptoms. 

The  asthmatic  symptoms  frequently  accompanying  bronchial  catarrh 
are  generally  quite  commonly  relieved  by  an  application  of  diathermy, 
or  thermo-penetration. 

Bright*s  Disease 

Different  forms  of  chronic  disease  of  the  kidneys,  commonly  known  as 
Bright 's  disease,  if  not  always  curable,  yield  most  encouraging  results. 
In  many  cases  both  albumin  and  casts  disappear  under  treatment.  ^  This 
result  may  be  expected  in  cases  in  which  the  treatment  is  applied  in  the 
early  stages  of  the  disease.  If  more  advanced,  much  may  be  done  to  ar- 
rest the  further  progress  of  the  malady  and  to  prolong  the  patient's  life 
by  maintaining  activity  of  the  skin  through  the  use  of  the  electric-light 
bath  and  the  various  tonic  applications  carefully  administered,  together 
with  a  suitable  dietary,  active  and  passive  exercises,  and  proper  applica- 
tions of  electricity. 

167 


ROENTGEN     CINEMATOGRAPH      (ROSENTHAL) 

168 


THE    BATTLE    CREEK    SANITARIUM 

The  intimate  causative  relation  of  intestinal  infection  to  tliis  disease 
is  now  most  clearly  recognized.  An  antitoxic  dietary,  and  such  hydriatic 
measures  as  dilate  the  vessels  of  the  liver  and  improve  its  nutrition,  while 
at  the  same  time  relieving  portal  congestion,  are  capable  of  accomplishing 
more  than  might  be  regarded  as  possible.  In  the  majority  of  cases,  the 
further  progress  of  the  disease  may  be  stayed  and  a  very  considerable  de- 
gree of  improvement  secured,  and  in  not  a  few  cases  the  recovery  is  appar- 
ently complete. 

The  employment  of  the  deehlorinated  dietary  is  found  to  be  very  im- 
portant in  bad  cases,  being  often  followed  by  the  disappearance  of  dropsi- 
cal effusions,  and  general  improvement  in  other  particulars. 

The  recent  discovery  of  the  fact  that  changes  in  the  blood-vessels  are 
present  in  most  cases  of  chronic  intestinal  nephritis,  renders  warm  or 
neutral  (not  hot)  baths,  so-called  Nauheim  baths,  and  a  large  variety  of 
other  hydriatic  applications  made  to  the  surface,  of  great  value  in  promoting 
the  activity  of  the  skin,  and  so  dilating  the  vessels  as  to  lighten  the  work 
of  the  heart. 

In  beginning  a  course  of  treatment  in  these  cases,  exhaustive  exami- 
nation is  made  of  the  urine.  The  coefficient  or  renal  efficiency  is  determined, 
with  the  other  urinary  coefficients,  and  the  effects  of  treatment  are  care- 
fully watched  by  the  comparison  of  the  coefficients  week  by  week.  It  is 
certain  that  life  in  most  cases  of  Bright 's  disease  may  be  very  greatly  pro- 
longed by  exact  regulation  of  the  dietary  and  the  systematic  application 
of  physiologic  measures  calculated  to  promote  intestinal  asepsis  and  activity 
of  the  skin. 

The  following  is  a  typical  daily  program  for  a  case  of  Bright 's  disease: 

Patient,  a  man  forty  years  of  age,  six  feet  in  height,  fairly  strong  and  with- 
out cardiac  complication. 

6:30  a.  m.— Dry  friction  in  bed. 

7:00.— Gentle  chest  exercises  in  the  gymnasium. 

7:30.— Breakfast. 

8:15.— Rest  for  45  min.  in  horizontal  position,  in  room  with  windows  open, 
or  in  the  open  air;  well  wrapped  in  cold  weather. 

9:30.— Exercise  for  half  an  hour  in  the  open  air. 
10:00.— Electric-light  hath   for  five  minutes,   followed  by   cold   mitten   friction 

and  massage. 
11 : 30.— Manual  Swedish  movements  and  breathing  exercises  for  thirty  mm. 
12:00.  — Sleep  for  one  hour  in  the  open  air  or  in  room  with  Avindows  open. 

1:00  p.  m.— Dinner. 

2:00.— Rest  for  one  hour  in  the  open  air  without  sleeping. 

3:00.  — Carriage  ride  40  min.,  or  walking  in  the  open  air  for  30  min. 

4:30.— Mechanical    Swedish    movements— abdominal    kneading,    vibration,    me- 
chanical massage. 

5:00.— High  frequency  current,   general  application,  to   lower  blood-pressiu-e. 

6:00.— Duneheon  of  fruit  or  yogurt. 

6:45. — Rest  half  an  hour. 

7:45. — Lecture  or  entertainment. 

9:15.— Application  of  moist  girdle  and  retiring,  sleeping  in  the  open  air  under 
awning  with  windows  wide  open,  or  with  window  tent  or  fresh-air  tube. 


RESPIRATION    APPARATUS    FOR   TESTING    THE    PATIENT'S    METABOLISM 

170 


THE    BATTLE    CREEK    SANITARIUM 

Pernicious  Anemia 

This  grave  malady,  while  not  yielding  constantly  successful  results,  is 
by  no  means  hopeless.  By  means  of  an  antitoxic  dietary,  chronic  auto- 
intoxication is  successfully  combated ;  and  by  the  application  of  well-tried 
hydriatic  measures,  especially  graduated  cold  procedures,  with  gentle  ap- 
plications of  massage  and  the  judicious  employment  of  electricity,  open-air 
treatment,  and  other  appropriate  physiologic  measures,  success  is  secured 
even  in  very  unpromising  cases.  By  the  exercise  of  judicious  care, 
the  improvement  secured  may  be  maintained,  as  has  been  demonstrated  by 
a  number  of  cases  which  have  been  kept  in  good  health  for  years  after  hav- 
ing been  given  up  as  quite  hopeless. 

The  recently  published  researches  of  Herter  and  others  leave  no  room 
for  doubt  that  pernicious  anemia  is  primarily  due  to  bacterial  in- 
fection of  the  intestine  and  absorption  into  the  blood  of  poisons  which  dis- 
solve the  blood  and  which  interfere  with  the  progress  of  hematogenesis. 
Herter  has  clearly  proved  the  relation  of  bacillus  aerogenes  capsulatus  to 
this  condition ;  hence  the  first  and  most  important  thing  to  be  done  in  these 
cases  is  to  combat  the  intestinal  autointoxication.  "When  the  intestine  has 
been  largely  cleared  of  the  invading  organisms,  the  blood  may  be  rapidly 
built  up  and  the  patient  restored  to  comfortable  health. 

Under  the  application  of  the  physiologic  method  of  dealing  with  these 
cases,  which  has  been  gradually  developed  within  the  last  thirty  years 
in  harmony  wdth  this  view,  the  blood-count  may  often  be  seen  to  double 
within  a  week  or  ten  days'  time,  and  a  restoration  of  the  blood-count  to 
the  normal  sometimes  takes  place  inside  of  three  or  four  weeks.  There  is 
certainly  no  other  method  whereby  so  excellent  results  can  be  obtained. 
One  of  the  greatest  of  all  the  advantages  of  this  method  of  dealing  with 
this  class  of  patients  is  that  when  the  patient  is  once  restored,  he  may  re- 
main well  if  he  will  adhere  closely  to  an  antitoxic  dietary  and  so  prevent 
a  new  infection  of  the  intestine.  The  great  difficulty  is  that  the  great 
majority  of  these  cases,  returning  to  the  ordinary  diet,  and  especially  by 
returning  to  the  use  of  flesh  foods,  reinfect  the  intestine,  re-establishing 
the  anaerobic  flora  with  which  flesh  foods  always  abound,  and,  by  reintro- 
ducing the  deadly  'bacillus  aerogenes  capsulatus,  one  of  the  chief  agents  of 
the  putrefaction  of  meat,  they  soon  suffer  anew  from  the  well-knovni 
symptoms  of  pernicious  anemia.  The  antitoxic  regimen  must  be  followed 
continuously  and  permanently.  On  no  other  condition  can  the  patient  hope 
to  escape  a  relapse.  AVith  this  condition  he  may  expect  to  retain  the  im- 
provement made  under  treatment. 

Not  infrequently  apparent  recoveries  have  been  secured  in  cases  which 
appeared  hopeless.  Many  cases  might  be  cited  in  which  this  disease,  gen- 
erally regarded  as  incurable,  has  yielded  most  excellent  results  under 
treatment.  It  must  be  remembered,  however,  that  every  case  of  pernicious 
anemia  is  associated  with  a  greatly  depreciated  organism,  so  that  a  prompt 
return  of  the  symptoms  may  be  expected  unless  the  patient  adheres  closely 
to  the  regimen  by  which  improvement  was  secured.  A  careful  study  of  the 
metabolism  of  the  patient  is  made  in  all  cases  of  anemia.  The  behavior  of 
the  case  under  various  dietetic  prescriptions  is  carefully  noted  and  graphic- 

171 


WHEEL    CHAIR    SOCIAL    ON    THE    LAWN- 


ONE    OF    THE    TENT    COLONIES 
172 


TIIK    I5A'I"1'LE    CREEK    SANITARII'M 

ally  recorded  so  that  the  rea(-tioa  of  the  body  to  the  various  changes  made 
may  be  readily  noted  and  a  dietary  selected  which  is  l)est  adapted  to  the 
patient's  condition. 

Drug   Habits 

Morphia,  cocaine,  and  alcohol  habits  are  rarely,  if  ever,  cui'ed  by 
antidotal  or  substitution  methods.  The  system  of  dealing  with  these  un- 
fortunate cases  which  has  been  developed  at  the  Battle  Creek  Sanitarium 
is  based  upon  the  successful  treatment  of  many  hundreds  of  individuals, 
and  demonstrates  the  superiority  of  the  physiologic  method  in  drug  addic- 
tion. Not  only  is  the  withdrawal  of  the  drug  not  attended  with  extraor- 
dinary suffering,  but  the  craving  for  the  drug  is  speedily  overcome,  and 
when  this  system  is  employed  in  a  thoroughgoing  way,  permanently  re- 
moved.   Incorrigible  or  objectionable  cases  are  not  received. 

"When  a  patient  of  this  class  is  received  into  the  institution,  he  is  put 
in  charge  of  two  attendants — one  for  the  day  and  the  other  for  the  night. 
He  is  constantly  under  supervision.  After  a  few  days  of  preparation  by 
means  of  electrical  baths  and  vigorous  tonic  treatment,  the  withdrawal  of 
the  drug  is  begun.  In  this  the  patient's  cooperation  is  solicited.  With  a 
little  encouragement  he  will  willingly  reduce  the  dose  one-half  each  day 
for  three  days,  and  at  the  end  of  the  third  day  will  drop  it  altogether. 

Very  rarely  is  any  considerable  degree  of  inconvenience  experienced 
during  more  than  the  first  twenty-four  hours.  The  attendant  stays 
by  the  patient,  doing  something  for  him  every  moment.  Gentle  friction  of 
the  limbs,  rubbing  of  the  spine,  hot  applications  to  the  spine,  a  neutral  bath, 
head  massage,  a  few  spoonfuls  of  food,  an  ice-bag  over  the  heart,  cool 
rubbing,  an  electric  bath,  an  air  bath — unceasingly  the  nurse  applies  one 
thing  after  another  as  the  various  symptoms  indicate,  thus,  not  only  pal- 
liating the  patient's  suffering,  but  diverting  his  mind  and  relieving  the 
tedium  of  the  passing  hours.  After  a  few  hours  the  distressing  symptoms 
grow  rapidly  less,  and  in  twenty-four  to  forty-eight  hours  the  patient, 
with  very  rare  exceptions,  finds  himself  delivered  from  the  galling  bondage 
which  has  held  him  fast. 

Chlorosis 

This  disease,  sometimes  so  obstinate  to  ordinary  methods  of  treatment, 
usually  yields  promptly  to  physiologic  measures.  The  electric-light  bath, 
the  sun  bath,  the  actinic  ray  of  the  arc  light,  followed  by  short  cold  ap- 
plications of  some  sort,  such  as  the  cold  mitten  friction,  the  towel  rub, 
effervescent  rub,  the  wet  sheet  rub,  or  the  shallow  bath,  quickly  change  the 
whole  complexion  of  the  case.  The  spasm  of  contracted  vessels  is  relaxed, 
bringing  the  glow  of  health  not  only  to  the  patient's  cheek,  but  to  the 
whole  cutaneous  surface.  A  general  quickening  of  all  the  vital  functions 
rapidly  replaces  the  enfeebled  tissues  by  a  sounder  growth,  builds  up  the 
blood,  restores  muscle  and  nerve  tone,  and  within  a  few  weeks  brings  the 
patient  to  complete  recovery. 

The  out-of-door  life,  swimming  baths,  and  gymnastics,  together  with 
massage  and  local  general  electric  applications,  are  wonderfully  helpful 
in  these  eases. 

17,3 


SCENES   ABOUT   THE    SANITARIUM   GROUNDS 
174 


THE    BATTLE    CREEK    SANITARIUM 

The  training  of  the  skin  l)y  daily  exposure  in  the  out-door  gymnasium 
in  the  summer  months  and  the  use  of  powerful  arc  lights  in  winter,  is  a  most 
valuable  aid  in  cases  of  this  kind. 

Perhaps  the  most  important  of  all  factors  in  these  cases  is  the  careful 
regulation  of  the  antitoxic  dietary  and  the  establishment  of  a  low  protein 
ration.  The  foundation  of  this  practice  is  the  belief  that  the  deterioration 
of  the  blood  is  only  in  small  part,  if  at  all,  due  to  a  deficiency  of  blood- 
making  elements,  but  is  due  to  the  absorption  into  the  blood  from  the  ali- 
mentary canal  of  poisons  by  which  the  blood-cells  are  destroyed  and 
hematopoietic  processes  interfered  with.  The  adoption  of  an  antitoxic  diet 
and  other  means  for  combating  intestinal  autointoxication  (see  page  13] ) 
rarely  fails  to  produce  prompt  and  satisfactory  results. 

Recovery  almost  always  begins  as  soon  as  the  patient  is  placed  under 
treatment.  The  improvement  can  be  noted  from  day  to  day  by  the  rise 
in  the  blood-count  and  hemoglobin.  An  increase  of  half  a  million  in  a  week 
is  very  common  in  the  blood-count. 

Obesity 

In  every  serious  case  of  obesity  a  thorough  study  is  made  of  the  patient's 
metabolic  processes  by  determination  of  the  nitrogen  balance  and  by  ob- 
taining the  respiratory  coefficient.  Daily  or  tri-weekly  examinations  of  the 
urine  are  made,  the  patient's  food  is  carefully  measured  out  to  him  in 
calories,  and  the  influence  of  the  various  foods  and  treatments  upon  his 
metabolism  is  carefully  noted  and  the  results  represented  upon  a  meta- 
bolism graphic. 

A  cure  may  always  be  effected  when  the  patient  is  able  to  carry  out 
the  regimen  required.  With  very  feeble  patients,  massage,  manual  Swedish 
movements,  and  applications  of  the  sinusoidal  electrical  current  may  suf- 
fice to  burn  up  the  surplus  fat.  Obese  patients  always  get  well  if  willing 
to  work  hard  and  persevere.  A  pound-a-day  loss  is  a  good  average  rate 
which  can  be  maintained  for  a  long  time  and  with  permanent  results. 
A  too  rapid  loss  is  not  wise. 

When  an  obese  person  places  himself  under  treatment  a  careful  history 
of  his  case  is  taken  and  a  thorough  physical  examination  is  made.  He  is 
then  weighed,  his  height  taken,  his  weight  coefficient  determined,  and,  by 
means  of  the  dynamometer,  the  strength  of  each  of  his  thirty  groups  of 
large  muscles  is  determined  and  plotted  on  a  chart ;  so  it  is  possible  to  see 
at  a  glance  his  exact  relation  to  the  average  person  of  his  own  height. 
His  strength  coefficient  indicates  the  amount  of  muscular  work  which  he 
should  do  daily.  His  strength-weight  coefficient  indicates  the  degree  to 
which  he  is  handicapped  on  account  of  his  weight.  His  height-weight  co- 
efficient shows  the  excess  of  fat. 

The  blood-pressure  is  obtained,  both  systolic  and  diastolic,  and  a  cardiac 
endurance  test  is  applied — a  very  important  determination  in  cases  of  this 
nature,  in  which  a  fatty  heart  may  be  easily  damaged  by  overexercise  or 
by  excessive  hot  or  cold  applications. 

Endurance  and  other  physical  tests  are  made,  and  the  results  are  care- 
fully considered.    > 

175 


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176 


THE    BATTLE    CREEK    SANITARIUM 

The  individual  patient  then  receives  a  carefully  adapted  presci-iption, 
which  usually  includes  the  following: 

1.  Eeduction  of  the  number  of  calories  to  a  half  or  a  third  the  amount 
required  for  an  ordinary  person  of  the  same  height.  For  example,  suppose 
a  woman's  height  to  be  65  inches;  her  normal  weight  should  be  3  20  lbs., 
but  her  actual  weight  is  2-iO  lbs.  The  number  of  calories  normally  re- 
quired by  this  woman  to  maintain  her  weight  and  strength  is  shown  by  the 
table  to  be  1,790  calories ;  that  is,  180  calories  of  proteins,  402  calories  of 
fats,  and  1,208  calories  of  carbohydrates.  The  patient  is  asked  to  eat,  say, 
1,000  calories — about  half  the  daily  requirement.  The  amount  of  protein 
will  not  be  reduced.  The  reduction  will  be  made  in  fats  and  carbohydrates 
principally.  That  is,  in  this  case  the  amount  of  proteins  would  remain  180 
calories;  the  fats  will  be  reduced  to  300  calories,  and  the  carbohydrates 
to  520  calories.  Sometimes  it  is  advantageous  to  eliminate  the  fats  en- 
tirely for  a  short  time,  but  patients  generally  do  better  if  allowed  a  moder- 
ate amount  of  fat,  as  this  serves  to  satisfy  their  craving  for  food,  and  the 
actual  number  of  calories  may  be  made  less  when  some  fat  is  supplied 
than  when  it  is  discarded  altogether. 

Occasionally  a  very  fleshy  patient,  desiring  to  reduce  flesh  rapidly, 
will  propose  to  fast  for  a  few  days.  If  the  general  strength  is  good,  this 
may  be  permitted,  but  not  otherwise.  Sometimes  the  patient  objects  to 
the  restriction  of  the  food  to  so  small  a  quantity.  Such  a  patient  is  told 
that  he  may  eat  as  much  as  he  likes,  provided  he  "will  eat  only  one  article 
of  food.  He  may  select  bread,  fruit — ^almost  any  article  he  chooses — 
provided  he  will  strictly  refrain  from  eating  any  other  kind  of  food. 
Breakfast,  dinner,  and  supper  the  diet  is  the  same — one  dish  only.  The 
monotony  of  the  diet  cuts  down  the  quantity  to  as  low  a  limit  as  is  de- 
sirable. 

So  long  as  the  patient  eats  less  than  the  actual  amount  of  food  required 
for  the  maintenance  of  a  normal  person  of  his  height,  he  is  bound  to  lose  in 
flesh,  and  the  greater  the  difi^erence  between  the  number  of  calories  he 
eats  and  the  normal,  the  more  rapid  his  loss  will  be. 

2.  The  patient  is  required  to  take  two  cool  baths  a  day,  their  length 
gradually  increasing  as  reactive  power  increases.  It  may  be  a  wet  sheet  rub, 
a  rubbing  shallow  bath,  a  spray,  or  a  sMdm.  The  effect  of  this  cold  bath  is  to 
burn  up  a  portion  of  the  unnecessary  residual  tissue  which  has  accumulated 
in  the  form  of  fat. 

A  prolonged  swimming  bath,  or  immersion  in  a  full  bath  at  a  tempera- 
ture of  78°  to  80°,  prolonged  for  thirty  or  forty  minutes,  with  moderate 
exercise,  will  so  increase  heat  production  as  to  consume  an  ounce  or  more 
of  fat. 

3.  Patients  in  whom  there  is  no  cardiac  indication  to  the  contrary, 
receive  twice  daily  an  electric-light  bath  or  some  other  form  of  sweating 
bath,  followed  by  a  cold  bath.  The  bath  should  be  managed  in  such  a  way 
as  to  secure  free  perspiration  for  fifteen  or  twenty  minutes.  This  also  in- 
creases oxidation,  and  so  results  in  the  burning  up  of  a  large  amount  of 
fat. 

4.  If  able  to  do  so,  the  patient  is  required  to  walk  an  increasing  dis- 
tance each  day.  A  patient  weighing  twice  the  normal  amount  will  con- 
sume an  ounce  of  fat  in  walking  a  mile  and  a  half  to  two  miles.     This  is 

177 


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NimSES,  ATTENDANTS  AND  EMPL(^-K 
178 


THE    BATTLE    CREEK    SANITARIUM 


due  to  the  increased  activity  of  the  combustion  i)rocess:es  of  the  body  as  a 
result  of  exercise.     Three  to  ten  miles  daily  soon  becomes  a  cheerful  task. 

5.  Persons  who  are  not  able  to  take  active  exercise  may  be  exercised 
vigorously  by  means  of  the  sinusoidal  current.  When  applied  by  means  of 
special  apparatus  devised  for  the  purpose,  all  the  leading  groups  of  muscles 
of  the  body  may  be  made  to  contract  simultaneously  under  the  stimulus  of 
the  sinusoidal  current.  By  weighting  the  muscles  with  sand  bags  after  the 
method  of  Bergeron,  the  muscles  may  be  made  to  do  any  amount  of  work 
desired.  The  work  may  be  concentrated  in  the  abdominal  region  or  any 
other  part  where  there  is  an  excessive  aceumulatifm  of  tiesh.  The  patient 
perspires  freely  after  the  treatment,  but  without  suffering  the  fatiguing 
effects  of  voluntary  exercise.  The  weight  may  be  reduced  by  this  means  at 
the  rate  of  a  pound  in  an  hour. 

6.  Diathermy  renders  very  great  service  in  these  cases.  By  appropriate 
applications  the  oxidation  of  fat,  both  local  and  general,  may  be  greatly 
stimulated.  By  this  method  massive  doses  of  electricity  may  be  converted 
into  heat  in  the  depths  of  the  tissues  and  thus  the  oxidation  processes  may 
be  stimulated  to  a  very  high  degree.  This  method  is  especially  useful  in 
cases  of  accumulation  of  fat  within  the  cavities  of  the  abdomen  and  chest, 
which  are  more  readily  influenced  by  this  measure  than  by  any  other. 

7.  In  certain  cases  the  over-accumulation  of  fat  is  now  known  to  be 
due  to  disturbances  of  the  functions  of  the  pituitary  body  or  of  the  thyroid 
gland.  In  these  cases  the  appropriate  measures  are  addressed  to  the  active 
cause  of  the  disease,  whatever  it  may  be.  in  conjunction  with  other  measures 
which  have  been  above  outlined. 

8.  ^Manual  Swedish  movements  are  also  an  important  factor  in  the 
treatment  of  these  cases.  Special  days  orders  are  provided  for  these  pa- 
tients, carefully  graduated  and  so  arranged  that  the  effect  may  be  con- 
centrated upon  any  particular  portion  of  the  body,  as  may  be  indicated. 
Special  attention  is  usually  directed  to  the  abdomen,  externally  or  in- 
ternally, or  to  the  hips. 

The  effect  of  these  special  movements  is  enhanced  by  various  local  ap- 
plications, such  as  the  sinusoidal  current  to  induce  passive  muscular  ex- 
ercise, and  the  heating  compress  to  promote  disintegration  and  absorption. 

The  heart  is  carefully  watched  so  that  it  shall  not  be  overtaxed,  and  the 
patient  is  required  to  report  his  weight  and  his  dietary  each  day,  while  the 
dynamometer  determines  whether  he  is  losing  or  gaining  in  strength. 

The  determination  of  the  height-weight  and  strength-weight  coefficients 
at  frequent  intervals  shows  with  mathematical  exactness  the  direction  and 
rate  of  progress.  An  obese  patient  may  experience  a  growth  of  muscle 
tissue  with  a  gain  in  strength  while  losing  fat,  but  without  any  change  in 
weight.  This  will  be  shown  by  the  improved  strength-weight  coefficient  and 
the  patient  will  be  encouraged  to  persevere  in  his  work.  The  reduction  of 
fat  is  necessarily  a  somewhat  tedious  and  strenuous  process,  and  the  patient 
needs  all  the  encouragement  his  case  and  progress  warrant. 

A  careful  eye  must  also  be  kept  upon  the  urinary  coefficients,  especially 
the  coefficients  of  demineralization  and  tissue  waste.  By  means  of  the  respira- 
tion apparatus  and  a  determinatioTi  of  the  respiratory  quotient,  it  is  possi- 
ble to  control  at  will  the  process  of  tissue  oxidation.    Too  rapid  tearing  down 


179 


GENTLEMAN    NURSES 


WOMEN     NURSES 
180 


THE    BATTLE    CREEK    SANITARIUM 

of  the  tissues,  aiul  especially  an  exaggerated  nitrogen  loss,  is  most  unde- 
sirable, leading  surely  to  disastrous  results.  Vigorous  measures  for  fat 
reduction  are  safe  only  when  checked  and  guarded  by  a  careful  scrutiny 
of  the  metabolic  processes,  such  as  is  afforded  by  carefully  worked  out 
coefficients. 

A  constant  loss  of  flesh  with  a  steady  gain  in  strength  is  a  certain  indi- 
cation that  the  patient  is  getting  on  well,  but  a  loss  of  flesh  with  a  loss  of 
strength  may  give  rise  to  pernicious  results,  and  demands  at  once  a  change 
of  program  to  avoid  disastrous  results. 

In  certain  cases  of  obesity  the  disorder  is  the  result  of  deficient  oxidation 
due  to  diminished  activity  of  the  thyroid  or  other  glands  of  internal  secre- 
tion. These  cases  require  the  use  of  the  remedies  indicated  in  addition  to 
the  other  measures  described. 

The  following  is  a  typical  day's  program  for  a  patient  suffering  from 
obesity : 

6:30  a.  m. — Water  drinking  (half  pint),  plunge  or  cold  shower  and  sv/iui. 

7:00.— Walk  1  to  2  miles. 

7:30.— Breakfast  on  half  ration. 

8:15. — Lying   down    for   thirty   minutes,   then    leg-raising   or   walking   on    all 

fours  for  fifteen  minutes,  or 
9:00. — Swedish  gymnastics  in  the  gymnasium. 
9:30. — Mechanical  exercise,  vibration  and  mechanical  massage. 
10:00.— Water  drinking   (half  pint),  electric-light  sweating  bath,  electric  thei'- 
mophore    pack,   wet    sheet    pack,    or   Russian    bath,    for   ten   to    thirty 
minutes,  folloAved  by  cold  shower  or  swim,  water  drinking   (half  pint). 
11:00.— Rest  thirty  minutes. 

11:30. — Manual  Swedish  movements — day's  order  for  obesity. 
12:00.— Walk  in  the  open  air,  one  to  three  miles.     Water  di'inking  (half  pint). 
1:00  p.  m.  — Dinner,— half  ration. 
2:00.- Rest  half  an  hour. 
2  :30. — Mechanical  movements. 

3:00.— Walk  one  to  two  miles.     Water  drinking  (half  pint). 
4:00.  — Sweating  bath  ten  minutes,  followed  by  swim  for  20  minutes.     Water 

drinking  (half  pint). 
5:00.— Electrical  gymnastics,  sinusoidal  current. 
6:00.  — Supper,  half  ration,  one  pint  of  liquid  food. 
7:00. — Calisthenics  in  gymnasium. 

8:00.— Walk  one  or  two  miles,  or  special  exercises  in  room. 
9:00.— Water  drinking   (half  pint),  apply  heatmg  compress. 
9:30.-Retiring. 

Rheumatoid   Arthritis 

Recent  studies  of  this  disease  have  given  good  grounds  for  the  belief  that 
it  is  simply  one  of  the  protean  forms  in  which  chronic  intestinal  autointox- 
ication manifests  itself.  That  chronic  rheumatism  and  rheumatoid  arthri- 
tis are  not  due  to  uric  acid  may  be  regarded  as  clearly  established ;  but  that 
they  are  due  to  poisons  generated  in  the  body  is  nevertheless  true,  and 
these  poisons  are  so  closely  associated  with  uric  acid  that  it  is  no  wonder 
that  the  latter  has  been  mistaken  for  the  real  mischief-maker.  The  writer 
is  fully  persuaded  that  the  principal  cause  of  chronic  rheumatism  is  toxins 
produced  in  the  colon  by  putrefactive  organisms  and  various  toxin-forming 
germs. 

181 


MUSEUM    AND   PATHOLOGICAL    DEPARTMENT 


'1^2 


THE    BATTLE    CREEK    SANITARIUM 

In  i^tudying  the  fecal  matters  of  patients  sulfering  from  rheumatism 
and  rheumatoid  arthritis,  an  extremely  infected  condition  of  the  colon  has 
been  constantly  found.  Six,  eight,  and  ten  billion  of  bacteria  per  gram  of 
dried  feces  are  common  observations.  It  is  no  wonder  that  metabolism 
should  be  seriously  disturbed  and  that  grave  structural  changes  should 
take  place  when  such  an  enormous  flood  of  toxins  is  continually,  year  after 
year,  poured  into  the  blood  from  the  colon,  as  must  be  the  case  with  such 
a  prodigious  putrefactive  flora  flourishing  in  the  alimentary  canal. 

The  regulation  of  the  dietary  is  a  matter  of  the  first  importance  in  these 
cases.  Indeed,  flesh  foods  must  be  entirely  discarded,  not  because  they 
contain  uric  acid,  but  because  the  undigested  residues  of  such  foodstuffs 
remaining  in  the  colon  promote  to  a  prodigious  degree  the  development  and 
increase  of  the  virulence  of  the  colon  bacteria,  and  consequently  the  develop- 
ment of  the  pernicious  toxins  to  which  this  disease  is  due.  This  has  been 
clearly  shown  by  Herter. 

The  patient  must  be  placed  upon  a  strictly  antitoxic  dietary.  Butter- 
milk and  yogurt  may  be  freely  used  with  advantage.  The  colon  is  washed 
out  by  large  enemas  daily,  and,  if  necessary,  twice  daily  for  a  time,  until 
the  bacterial  count  is  reduced  to  somewhere  near  the  normal  point. 

The  general  treatment  consists  of  short  electric  light  baths,  followed  by 
cool  rubbings.  The  purpose  of  the  light  bath  is  to  increase  the  activity  of  the 
«kin  and  to  improve  metabolism.  There  is  no  virtue  in  prolonged  sweating 
in  these  cases.  Many  cases  have  been  greatly  damaged  by  long  sweating 
T^aths  and  other  debilitating  treatment  at  various  mineral  springs. 

All  sorts  of  thermic  applications  are  made  to  the  joints.  Most  ef- 
fective are  the  fomentation,  the  photophore,  and  the  electric  thermophore. 
A  much  higher  skin  temperature  can  be  secured  with  the  photophore  than 
v^dth  the  hot-air  apparatus.  The  latter  is  cumbersome  and  somewhat  danger- 
ous, and  yet  goocl  results  are  obtained  by  it.  All  hot  applications  are 
useful. 

After  the  hot  application  the  heating  compress  is  applied.  This  con- 
sists of  a  toAvel,  wrung  dry  out  of  cold  water,  wrapped  about  the  affected 
joint,  including  the  limb  for  a  little  distance  above  and  below.  This  is 
covered  with  mackintosh;  then  thick  flannel  wrappings  are  applied  so  as 
to  secure  quick  heating  and  retention  of  the  heat.  The  heating  compress  re- 
mains until  the  next  thermic  application.  A  hot  application  of  some 
sort  is  made  two  or  three  times  daily. 

The  development  of  the  wasted  muscles  is  secured  by  employment  of  the 
sinusoidal  current,  massage,  and  passive  movements.  Sun  baths  and  the 
arc  light,  and  in  summer-time  the  sand  bath  and  open  air  treatment  are 
found  of  great  value  in  these  cases  through  their  invigorating  effect  upon 
the  skin.  The  effervescing  bath  (Nauheim),  the  effervescent  rub,  the  salt 
glow,  and  dry  friction  enter  into  the  program.  Radium  emanation  or  niton, 
employed  by  inhalation,  emanation  baths,  or  the  so-called  "drink  cure" 
renders  great  service  in  relieving  pain  and  other  symptoms  in  some  cases 
in  which  other  measures  have  proven  ineffective.  The  respiratory  quotient 
determined  by  the  respiratory  apparatus  of  Benedict  is  also  extremely  use- 
ful for  this  purpose. 

Diathermy  affords  a  means  by  which  heat  may  be  applied  to  the  internal 

■1S3 


184 


THE    BATTLE    CREEK    SANITARIUM 

structures  more  effectively  than  by  any  other  means.  One-half  an  ampere 
to  an  ampere  of  current  may  be  passed  through  a  defective  joint  without 
effecting  the  slightest  pain  or  other  sensation  than  that  of  heat.  By  this 
means  the  temperature  of  the  internal  part  may  be  raised  four  or  five  de- 
grees, and  the  powerful  stimulating  effects  of  heat  may  be  brought  to 
bear  upon  parts  remote  from  the  surface  and  otherwise  inaccessible. 

Cases  are  very  rare  in  which  material  benefit  can  not  be  obtained  by 
application  of  the  measures  mentioned  above  and  allied  means.  The  treat- 
ment must  sometimes  be  continued  during  several  months  to  secure  the 
maximum  results,  but  since  the  recognition  of  the  part  played  by  the 
colon  infection  as  a  causative  factor  in  this  disease,  the  time  required  to 
secure  large  results  has  been  reduced  one-half,  or  even  more. 

Diabetes 

The  general  plan  followed  in  the  treatment  of  diabetes  is  the  excellent 
system  worked  out  by  Prof.  Von  Noorden  and  his  pupils,  Prof.  Falta  and 
others.  Bearing  in  mind  the  fact  that  the  source  of  most  imminent  danger  to 
the  diabetic  patient  is  not  the  amount  of  sugar  he  discharges  in  his  urine, 
but  his  inability  to  store  glycogen  in  his  liver  and  muscles,  one  of  the 
first  steps  is  the  determination  of  the  patient 's  condition  in  respect  to  glyco- 
gen storage  by  obtaining  his  respiratory  quotient.  This  is  done  by  means  of 
the  excellent  apparatus  developed  by  Benedict  in  the  Carnegie  Nutrition 
Laboratory  at  Boston.  If  a  quotient  of  70  or  less  is  obtained  after  a  liberal 
dose  of  carbohydrates,  instead  of  the  normal  80,  this  means  no  storage 
of  glycogen  and  signifies  a  very  grave  case.  A  coefficient  of  72  or  73  shows 
still  a  sufficient  storage  power  to  give  a  good  chance  for  improvement. 

The  next  step  is  to  find  out  the  max;imum  amount  of  carbohydrates  that 
the  patient  can  safely  take  and  to  increase  his  tolerance  for  carbohydrates 
through  careful  training  by  green  diet  and  by  the  improvement  of  the 
patient's  general  vital  condition.  The  very  constant  association  of  intestinal 
putrefaction  with  grave  cases  of  diabetes  to  which  attention  has  been  called 
by  Von  Noorden  and  Falta  is  an  indication  for  close  attention  to  the  in- 
testinal flora  and  the  use  of  special  treatment  to  combat  development  of  in- 
testinal intoxication  which  is  greatly  favored  by  the  restriction  of  carbohy- 
drates and  increase  of  fats  and  proteins  which  is  necessary  in  this  disease. 
The  patient's  bowels  are  made  to  move  three  times  a  day  by  means  of  mas- 
sage, manual  and  mechanical  Swedish  movements,  the  use  of  a  very  laxative 
diet  in  which  definite  amounts  of  cellulose  are  given,  and  by  other  natural 
means. 

Special  cultures  of  antitoxic  ferments  are  freely  given.  A  culture  con- 
taining active  growths  of  Bacillus  Bulgaricus,  Bacillus  Mftdus  (Tissier), 
and  Bacillus  Glycohacter  (Wollman,  Distaso),  has  been  found  most  ef- 
fective in  changing  the  intestinal  flora  and  combating  intestinal  intoxication 
in  diabetes  as  well  as  in  other  disorders  associated  with  chronic  toxemia. 

A  variety  of  gluten  breads  and  many  other  preparations  specially  de- 
signed for  diabetes  are  provided,  including  the  greatest  possible  variety  of 
green  vegetables,  such  as  artichokes,  Japanese  krosnes,  Chinese  cabbage,  a 
great  abundance  of  lettuce  fresh  from  the  Sanitarium  greenhouses,  dasheen 
bulbs  and  shoots,  and  all  sorts  of  greens. 

185 


186 


THE    BATTLE    CKKEK    SANITARIUM 

Every  dial)etic  patient  is  put  under  the  care  of  a  trained  dietitian  wlio 
under  supervision  of  his  physician  regulates  his  diet  and  caters  to  his 
needs  and  tastes. 

At  the  beginning  with  tliese  cases  the  patient  is  put  under  close  ob- 
servation for  two  weeks,  during  which  time  daily  quantitative  examinations 
of  the  urine  are  made  and  the  effects  of  various  dietaries  are  carefully 
studied.  It  is  expected  within  the  two  weeks  to  determine  not  only  the  pro- 
portion of  fat  and  protein  adapted  to  the  individual's  condition,  but  also 
the  particular  variety  of  starch  which  he  can  best  utilize.  ]\Iuch  light  is 
thrown  on  these  cases  by  a  study  of  the  respiratory  coefficient,  the  best  means 
of  determining  the  patient's  ability  to  store  glycogen,  upon  which  the 
prolongation  of  his  life  depends  more  perhaps  than  upon  any  other  single 
factor.  By  means  of  this  close  scrutiny  and  the  nice  discrimination  which 
this  method  permits,  surprisingly  good  results  may  often  be  obtained  evan 
in  the  most  unpromising  cases. 

By  careful  quantitative  examination  of  the  urine  daily  or  every  other 
day,  and  a  daily  record  of  the  patient's  diet  measured  in  calories  of  protein, 
fats  and  carbohydrates,  exact  data  may  be  gathered  by  means  of  which  a 
complete  knowledge  of  the  metabolic  processes  may  be  obtained  and  the  ef- 
fects of  changes  in  diet  or  treatment  may  be  noted.  The  examination  of  the 
urine  includes  the  following  determinations:  the  quantity,  total  nitrogen, 
urea,  ammonia,  diacetic  acid,  acetone,  sugar,  indican,  indol  acetic  acid 
•and  chlorids.     Other  determinations  are  made  as  necessary. 

In  estimating  the  amount  of  food  sugar,  starch  is  converted  into  dex- 
trose by  the  addition  of  ten  per  cent  of  its  weight,  and  the  sugar  derived 
from  the  protein  oxidized  in  the  body  is  estimated  by  multiplying  the  total 
nitrogen  of  the  urine  by  the  factor  3.65.  If  we  subtract  the  urinary  sugar 
from  the  food  sugar,  the  remainder  would  indicate  the  amount  of  sugar 
assimilated.  By  dividing  this  remainder  by  the  total  food  sugar,  we  may 
ascertain  the  percentage  of  the  food  sugar  which  has  been  utilized — the 
coefficient  of  sugar  utilization. 

All  the  above  data,  together  with  the  patient's  weight,  which  is  taken 
daily,  is  graphically  represented  as  shown  in  the  accompanying  reproduction 
of  a  Metabolism  Graphic.  Determination  of  the  nitrogen  balance  reveals 
loss  or  gain  in  the  nitrogenous  tissues.  For  example,  if  the  nitrogen  balance 
is  minus  3,  we  know  there  has  been  body  consumption  with  a  loss  of  three 
ounces  of  nitrogenous  tissue,  since  each  gram  of  nitrogen  represents  thirty 
grams  of  tissue  (Voit  and  Pettenkofer). 

It  has  recently  been  shown  by  Benedict  that  in  diabetes  oxidation  is 
increased  rather  than  diminished.  This  fact  renders  highly  important  a 
close  scrutiny  of  the  protein  and  fat  metabolism,  as  well  as  of  the  sugar 
utilization  and  a  determination  of  the  respiratory  coefficient.  The  rise  and 
fall  of  the  acidosis  curve  is  also  watched  with  very  great  interest.  By  this 
means  it  is  possible  to  recognize  the  approach  of  diabetic  coma  in  severe 
cases  in  which  the  excessive  oxidation  of  fat  and  protein  leads  to  the  pro- 
duction of  beta-oxybutyric  acid  and  its  derivatives. 

The  importance  of  the  frequent  determination  and  most  careful  scrutiny 
of  the  coefficients  relating  to  metabolic  change  in  these  cases  can  scarcely  be 
overstated.     Neglect  to  do  this  while  making  use  of  such  powerful  physi- 

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188 


THE    BATTLE    CREEK    SANITARIUM 

ologic  means  as  are  needed  to  definitely  influence  general  oxidation  pro- 
cesses may  easily  lead  to  fatal  mischief  by  favoring  the  development  of 
acidosis  and  other  grave  complications.  Physiologic  measures  are  like  steam 
hammers.  They  strike  smashing  blows,  but  must  be  accurately  aimed,  else 
irreparable  mischief  may  be  done. 

The  patient's  weight  and  strength  are  watched,  while  measures  calcu- 
lated to  improve  oxidation  are  applied  with  gradually  increasing  vigor. 
These  measures  are  essentially  the  same  as  those  employed  for  obesity,  but 
extreme  care  is  exercised  not  to  administer  prolonged  cold  baths,  especially 
in  cases  in  which  sugar  is  found  in  the  perspiration.  Prolonged  hot  baths 
are  also  avoided,  as  well  as  other  depressing  measures. 

Emaciated  patients,  and  all  cases  in  which  the  urea  coefficient  is  high, 
are  restricted  as  regards  exercise.  The  attending  physician  is  constantly  on 
the  lookout  for  the  slightest  appearance  of  any  symptom  pointing  toward 
diabetic  coma. 

The  results  obtained  are  often  very  gratifying.  Chronic  cases  are  rarely 
cured  entirely,  but  the  amount  of  sugar  is  greatly  decreased,  and,  by 
proper  regimen,  is  often  held  down  to  a  low  point.  In  mild  cases  the  sugar 
usually  disappears  from  the  urine.  The  important  thing  is  to  teach  the  pa- 
tient how  to  regulate  his  diet  and  his  habits  so  as  to  enable  him  to  live  and 
enjoy  life  as  long  as  possible  with  a  crippled  organism. 

The  Metabolism  Graphic  prepared  by  the  dietitian  shows  the  physician 
instantly  any  adverse  trend  of  the  case,  and  thus  enables  him  to  foresee  and 
prevent  the  development  of  diabetic  coma  and  other  grave  conditions. 

Cardio- Vascular-Renal  Disease — 

There  is  no  class  of  maladies  in  which  the  physiologic  method,  and 
especially  the  combined  method  of  physiologic  therapeutics  which  constitute 
the  Battle  Creek  Sanitarium  System  shows  its  efficiency  to  better  advantage 
than  in  the  treatment  of  cardio-vascular-renal  disorders. 

The  three  classes  of  maladies,  cardiac,  vascular  and  renal,  are  considered 
together  because  of  the  frequency  with  which  they  are  associated,  especially 
in  the  advanced  and  secondary  forms  which  are  likely  to  come  under  the 
care  of  the  Sanitarium  physician. 

In  cases  of  organic  disease  of  the  heart  with  primary  low  blood-pressure, 
most  brilliant  results  are  often  secured. 

The  hypotension  and  resulting  passive  congestion  of  kidneys,  liver, 
stomach  and  bowels,  and  the  results  which  follow  this  visceral  stasis,  are 
more  amenable  to  physiologic  measures  than  to  any  other.  Carefully  con- 
ducted tonic  baths,  particularly  cold  rubbings,  as  the  cold  mitten  friction, 
cold  towel  rub,  half -sheet  rub,  and  later  the  rubbing  shallow,  the  spray,  and 
the  douche,  afford  a  graduated  method  by  which  the  tone  both  of  the 
heart  and  the  vessels  may  be  greatly  improved. 

The  cold  precordial  compress,  especially  the  cooling  coil,  affords  a 
means  of  increasing  the  energy  and  efficiency  of  the  heart  far  superior  to 
any  drug  yet  discovered.  This  method  has  been  called  the  hydriatic 
digitalis,  but  it  is  far  superior  to  digitalis  in  the  fact  that  it  increases  the 
energy  of  the  heart  without  increasing  the  resistance  in  the  blood  circuit. 
It  has  no  cumulative  effect  and  it  does  not  lose  its  efficiency  by  continued 

189 


THE    BATTLE    CREEK    SANITARIUM 

use.  Tliat  tliis  measuie  is;  capable  ol:'  doiiiy  liai'in  as  well  as  good,  especially 
in  cases  of  cardiac  dilatation,  does  not  diminish  its  value,  but  only  empha- 
sizes the  necessity  for  expertness  and  discrimination  in  its  use. 

Visceral  congestion  is  combated  by  the  sitz-bath,  wet  girdle,  the  re- 
vulsive application  to  the  spine,  the  salt  glow,  oil  friction,  massage  and 
other  measures  whereby  collateral  hyperemia  of  the  skin  and  superficial 
parts  is  established,  thus  relieving  the  deeper-lying  structures. 

A  definite  elevalion  of  blood-pressure,  15  to  30  millimeters,  is  commonly 
i]o1ed  within  a  week  or  two  after  the  beginning  of  treatment  in  these  cases. 
The  albumin,  which  in  advanced  cases  is  often  found  present  in  the  urine, 
usually  disappears.  Carefully  administered  tonic  hydriatic  applications 
improve  the  metabolism,  appetite  returns,  tissue  wastes  are  eliminated, 
there  is  increased  vital  resistance  with  improvement  in  the  blood  and  se- 
cretions. The  intestinal  intoxication  which  in  these  cases  is  usually  a  promi- 
nent feature,  rapidly  diminishes,  as  shown  by  diminished  output  of  indol 
in  the  feces  and  of  the  indican  in  the  urine.  By  means  of  the  colorimetric 
method  the  estimation  of  these  products  is  made  with  accuracy,  so  that  the 
diminution  of  the  toxemia  under  a  carefullv  arranged  antitoxic  regimen 


ASTHMATIC    PATIENT    BREATHING    IN     RAREFIED    AIR 


with  special  cultures  of  antitoxic  ferments  and  tonic  measures  of  treatment 
can  be  readily  observed  from  day  to  day. 

A  point  in  prognosis  to  which  attention  is  always  given  is  the  determi- 
nation of  the  excretory  efficiency  of  the  kidney,  both  as  regards  mineral 
salts  and  urea.  By  the  careful  determination  of  a  score  or  more  of  renal 
coefficients  and  a  special  test  for  renal  efficiency  and  for  water  elimination, 

191 


192 


THE    BATTLE    CREEK    SANITARIUM 

a  very  close  estimate  can  be  formed  of  the  degree  of  damage  whioh 
the  secreting  structures  of  the  kidney  have  sustained.  This  is  found  a 
matter  of  much  importance,  not  only  from  the  standpoint  of  prognosis, 
but  also  from  that  of  practical  therapeutics.  When  the  ability  of  the 
kidneys  to  eliminate  chlorid  is  found  to  be  diminished,  the  use  of  chlorid 
of  sodium  is  restricted ;  and  where  dropsy  is  present,  a  saltless  diet  is  ad- 
ministered ;  and  it  is  often  most  gratifying  to  note  the  rapidity  with  which 
the  dropsy  disappears  under  this  regimen  in  connection  with  suitable  and 
carefully  graduated  diaphoretic  measures,  such  as  the  electric-light  bath 
restricted  to  the  legs,  the  half-blanket  pack,  and  other  partial  diaphoretic 
measures  associated  with  the  precordial  cooling  coil,  or  a  cooling  chest 
compress. 

In  grave  cases  the  observation  of  the  blood-pressure  before,  after,  and 
even  during  an  application  renders  possible  an  exact  adaptation  of  measures 
to  the  patient's  needs.  This  precaution  is  required  in  not  a  few  cases  in 
which  marked  cardiac  dilatation  is  present. 

In  certain  cases  of  cardiac  insufficiency,  especially  in  cases  of  so-called 
cardiac  asthma,  the  patient  is  greatly  relieved  by  breathing  into  rarefied 
air.  The  degree  of  vacuum  employed  is  a  one-inch  mercury  column,  or 
six  to  eight  inches  water  column.  By  this  means,  which  is  found  especially 
beneficial  in  cases  of  dilatation  of  the  right  ventricle  of  the  heart,  the  suc- 
tion power  of  the  heart  is  improved,  the  movement  of  blood  through  the 
lungs  is  accelerated,  the  respiratory  rhythm  is  regulated,  and  in  favorable 
cases  a  very  great  amelioration  of  the  patient's  symptoms  is  at  once  recog- 
nizable. The  arrangement  of  the  special  apparatus  which  has  been  con- 
structed for  this  purpose  is  such  as  to  permit  the  use  of  oxygen  in  any 
required  proportion  when  it  is  found  desirable. 

Aerotherapy 

Aerotherapy  in  various  forms  is  employed  in  cases  requiring  this  phys- 
iologic measure.  Apparatus  is  provided  by  which  patients  may  respire 
air  under  diminished  or  increased  pressure,  as  may  be  desired.  Oxygen 
or  medicated  vapors  are  used  in  combination  with  air  when  indicated. 

The  breathing  of  rarefied  air  is  found  especially  beneficial  in  certain 
cases  of  cardiac  insufficiency,  especially  in  cases  of  cardiac  asthma,  and  in 
certain  cases  in  which  the  lung  is  crippled  by  adhesions,  and  whenever  it  is 
desirable  to  aid  the  pulmonary  circulation  or  to  regulate  rhythm  by  de- 
creasing the  period  of  expiration  and  increasing  the  inspiratory  period. 

Special  apparatus  is  provided  for  inhalation  of  oxygen  in  measured 
doses,  and  the  pulmotor  is  used  for  automatic  respiration  when  necessary. 
The  pulmotor  when  connected  with  the  respiratory  organs  by  means  of  a 
suitable  mask  attached  to  the  face,  carries  on  automatically  a  most  efficient 
artificial  respiration,  first  forcing  oxygen  into  the  lungs,  then  withdrawing 
it,  and  repeating  the  process  at  a  rate  a  little  more  rapid  than  that  of  ordi- 
nary respiration.  This  instrument  is  always  at  hand  ready  for  instant  use 
in  case  of  an  emergency,  either  in  connection  with  artificial  anesthesia  or 
as  the  result  of  accidental  asphyxiation  from  any  cause. 

193 


194 


THE    BATTLE    CREEK    SANITARIUM 

Arteriosclerosis 

When  symptoms  of  renal  disease  are  present,  especially  in  connection 
with  evidence  of  cardiac  failure,  a  searching  inquiry  is  made  to  determine 
if  possible  whether  or  not  the  kidney  lesion  is  primary  or  secondary.  This 
naturally  leads  to  a  careful  study  of  the  condition  of  the  vessels.  Not  in- 
frequently, in  cases  of  beginning  secondary  low  pressure,  the  blood-pressure, 
though  much  above  the  normal,  may  rise  20  to  30  millimeters  during  the 
first  weeks  of  treatment  with  a  corresponding  improvement  in  all  the  general 
symptoms.  The  high  blood-pressure  is  of  course  necessary  to  the  mainten- 
ance of  the  functions  of  the  kidneys  and  other  organs  in  which  the  blood- 
vessels are  obstructed  by  degenerative  changes.  Later  a  gradual  fall  of 
pressure  occurs.  In  cases  in  which  extensive  calcareous  degeneration  has 
not  yet  taken  place,  in  fact,  in  the  great  majority  of  cases  of  hypertension, 
a  very  marked  loM'ering  of  blood-pressure  is  secured. 

The  low  protein  and  antitoxic  regimen  generally  brings  clown  the  blood- 
pressure  from  10  to  30  millimeters  within  a  couple  of  weeks  by  lessening  the 
amount  of  pressure-raising  toxins  in  the  body  fluids.  In  cases  of  begin- 
ning secondary  hypotension  this  beneficial  effect  is  obscured  by  the  im- 
provement in  the  heart  action  which  occurs  at  the  same  time  as  the  result 
of  tonic  hydriatic  applications  and  hyclriatic  heart  tonics  which  are  em- 
ployed, the  tendency  of  which  is  to  increase  blood-pressure.  The  diminu- 
tion or  disappearance  of  dropsy,  the  improvement  in  the  urinary  secre- 
tion, the  improved  renal  coefficient,  the  disappearance  of  mental  and  nervous 
symptoms  due  to  cerebral  edema,  the  improved  appearance  of  the  skin  and 
the  general  improvement  in  the  patient's  strength  and  feelings  afford 
abundant  evidence  of  arrest  of  morbid  processes  and  improved  conditions. 

Later,  as  the  general  metabolism  is  improved  under  dietetic  regulation 
and  graduated  physiologic  applications  of  water,  electricity,  massage, 
special  cardiac  movements  (Ling  or  Schott  system),  the  effervescing  bath 
and  other  appropriate  measures,  the  blood-pressure  gradually  falls,  some- 
times to  two-thirds  or  even  one-half  the  maximum  record. 

These  cases  are  ahvays  highly  interesting,  and  results  are  rarely  dis- 
appointing. "While  a  few  eases  are  encountered  in  which  the  patient  has 
waited  so  long  that  nothing  more  can  be  clone  than  to  palliate  his  sufferings 
and  prolong  his  life  for  a  few  months,  the  renal  tissues  having  become  so 
far  degenerated  that  there  is  not  enough  secreting  tissue  left  to  do  the  neces- 
sary work  required  to  free  the  blood  from  body-toxins,  a  large  number  of 
cases  are  met  in  which  the  improvement  in  the  patient's  condition  is  so 
rapid  and  so  great  as  to  seem  almost  miraculous. 

It  is  certainly  proper  to  say  that  there  is  no  class  of  cases  in  which  the 
■advantages  of  the  Sanitarium  method  are  more  apparent  and  the  need  of 
'Sanitarium  care  and  treatment  more  urgent  than  in  this  class  of  cases. 
It  is  proper,  however,  to  emphasize  the  fact  that  there  is  no  class  of  cases 
in  which  irreparable  injury  may  be  so  easily  and  quickly  done  by  the 
incompetent  or  improperly  controlled  application  of  hydriatic  methods, 
■either  hot  or  cold,  as  in  this  class  of  disorders.  For  example,  the  cold 
cardiac  compress  is  the  most  efficient  means  of  stimulating  the  heart's 
action,  but  when  suddenly  applied  in  a  case  of  lost  compensation  with  ex- 
treme cardiac  dilatation,  the  patient  may  be  almost  as  certainly  and  as 

19.5 


THE    SURGICAL   OPERATING   DEPARTMENT 
196 


THE    BATTLE    CREEK    SANITARIUM 

suddenly  killed  as  though  shot  through  the  heart  with  a  bullet.  In  ad- 
vanced cases  of  arteriosclerosis,  either  a  very  hot  or  a  very  cold  bath  may 
cause  death  by  apoplexy.  A  hot  bath  may  produce  such  great  depres- 
sion in  a  case  of  either  primary  or  secondary  hypotension  as  to  cause  death 
either  at  once  or  a  few  hours  later.  Nothing  could  be  more  dangerous 
than  a  haphazard  or  inexpert  application  of  hot  or  cold  baths,  or  even 
massage  or  movements  in  cases  of  this  sort. 

Marked  beneficial  effects  are  often  observed  from  the  application  of 
the  high  tension  current.  The  effects,  however,  of  this  measure  are  gen- 
erally only  temporary,  consequently  it  has  little  curative  value  except 
when  used  in  connection  with  measures  which  remove  the  causes  of  hyper- 
tension, especially  elimination  of  the  pressure-raising  toxins  from  the 
circulation. 

Diathermy  and  the  use  of  radium  emanation  have  in  recent  years  been 
shown  to  be  highly  valuable  measures  in  the  treatment  of  arteriosclerosis. 

This  is  especially  true  of  diathermy.  A  current  of  2-4  amperes  applied 
to  the  spine  and  abdomen  often  lowers  the  blood-pressure  twenty  to  forty 
points  in  fifteen  minutes.  Under  daily  applications  the  pressure  steadily 
falls  from  day  to  day,  sometimes  returning  nearly  to  normal.  The  effect  is 
obtained  by  dilatation  of  the  splanchnic  vessels. 

The  Surgical  Ward 

While  surgery  is  not  a  chief  feature  in  the  Sanitarium,  specially  favorable 
conditions  are  afforded  to  those  requiring  surgical  attention.  To  the  care  of 
skilled  surgeons  is  added  the  superior  methods  of  nursing,  which  greatly 
lessen  the  inconveniences  and  the  dangers  in  grave  surgical  cases.  Up-to- 
date  operating  rooms,  aseptic  wards,  and  conscientious  surgical  nurses  and 
assistants  make  this  department  successful  in  saving  the  lives  of  hundreds 
of  cases  annually ;  but  the  physicians  take  special  pride  in  restoring  their 
patients  to  health  without  surgery  when  possible,  considering  a  cure  by  non- 
surgical means  a  far  greater  triumph  than  the  most  brilliant  surgical  pro- 
cedure. 

The  Medical  Staff 

The  medical  corps  of  the  Battle  Creek  Sanitarium  comprises  more 
than  twenty  physicians,  and  from  200  to  350  nurses  and  attendants,  the 
number  varying  with  the  season  of  the  year.  The  physicians  are  all  men 
and  women  who  have  received  a  thorough  modern  medical  training,  are 
graduates  of  reputable  colleges,  and  possessed  of  the  legal  requirements 
for  the  practice  of  medicine. 

In  addition  to  the  ordinary  medical  equipment,  these  physicians  have 
all  received  special  training  for  five  to  twenty  years  or  more  in  the  prin- 
ciples and  practical  applications  of  the  Battle  Creek  Sanitarium  system  of 
physiologic  medicine.  The  physiologic  method,  like  surgery,  can  not  be 
learned  from  a  book.  It  depends  so  largely  upon  exactness  of  technique 
m  the  employment  of  agencies  which  require  physical  means,  instruments, 
and  apparatus,  a  large  training  of  hand  and  eye,  and  the  development  of 
the  therapeutic  judgment  by  actual  experience,  that  only  those  who  have 

197 


THE    BATTLE    CREEK    SANITARIUM 

had  special  training  can  hope  to  obtain  in  its  application  the  largest  and 
hest  results. 

It  must  be  said,  on  the  other  hand,  however,  that  there  is  no  system  of 
therapeutics  which  compares  with  the  physiologic  method  in  versatility  of 
application  and  adaptation  to  emergency  conditions  of  every  sort.  Every 
home  affords  the  means  necessary  for  the  employment  of  the  physiologic 
method,  but  of  course  in  a  restricted  way. 

The  Sanitarium  aims  to  make  the  largest  and  most  efficient  use  of 
natural  or  physiologic  methods  possible,  and  the  constant  effort  toward  the 
accomplishment  of  this  end  has  developed  a  broad  and  more  or  less  com- 
plex system,  presenting  hundreds  of  measures,  means,  and  methods,  each 
of  which  has  a  technique  of  its  own,  and  indications  and  contraindications 
the  recognition  of  which  is  essential  to  success. 

The  leading  physicians  of  the  Battle  Creek  Sanitarium  have  been 
actively  connected  with  the  institution  for  ten  to  thirty  years.  All  have 
been  specially  trained  for  their  work  in  the  best  medical  educational  in- 
stitutions of  this  country  and  Europe.  None  are  allowed  to  take  the  re- 
sponsibility of  managing  cases  who  have  not  had  at  least  several  years' 
experience  with  the  Battle  Creek  Sanitarium  system.  But  the  largest 
experience  would  enable  the  physicians  of  the  institution  to  accomplish 
little  were  it  not  for  the  aid  which  they  receive  from  the  laboratory  ex- 
perts in  working  out  an  accurate  and  complete  diagnosis,  and  the  co- 
operation of  an  army  of  trained  nurses,  dietitians,  and  attendants,  who. 
with,  untiring,  conscientious  skill,  carry  out  prescriptions  at  the  bedside  and 
in  the  various  branches  of  the  treatment  department. 

The  management  of  the  Battle  Creek  Sanitarium  feels  exceedingly 
grateful  for  the  generous  support  and  cooperation  which  has  been  accorded 
it  by  the  members  of  the  profession  in  all  parts  of  the  United  States,  as  well 
as  in  foreign  lands,  where  the  most  eminent  medical  bodies  accord  to  the 
institution  the  same  standing  as  that  of  any  other  well-organized  public  hos- 
pital. It  will  be  the  most  earnest  endeavor  of  the  managers  and  faculty  of 
the  institution  to  make  it  in  the  future  still  more  deserving  of  confidence 
and  patronage,  and  to  maintain  its  standing  as  a  leading  exponent  of 
physiologic  medicine. 

Any  reputable  physician  who  desires  to  inspect  the  institution  or  to 
investigate  its  methods  of  treatment  and  clinical  research,  will  be  cordially 
received  as  a  guest  for  a  day  or  two  at  any  time  on  application  to  the 
Medical  Office  or  the  Superintendent.  A  surgical  clinic  is  held  on  Wednes- 
day, and  usually  on  one  or  two  other  days  each  week. 

Letters  from  physicians  introducing  patients  are  often  of  great  service 
and  are  always  gratefully  received.  It  is  the  policy  and  practice  of  this 
institution  to  cooperate  with  the  home  or  attending  physician,  not  to  super- 
sede or  antagonize  him.  The  mutual  aim  and  interest  is  the  recovery  of  the 
patient  in  the  shortest  possible  time  and  to  the  most  thorough  extent  pos- 
sible. No  method  is  employed  which  will  not  receive  the  endorsement  of 
any  scientific  physician.  The  members  of  the  medical  staff  are  always 
ready  to  send  to  the  attending  physician  not  only  a  full  report  of  the  find- 
ings in  the  ease,  but  also,  when  desired,  an  account  of  the  measures  of  treat- 
ment employed. 

198 


THE    BATTLE    CREEK    SANITARIUM 


UbSTETKiOAL    DEPARTMENT 

The  Obstetrical  Ward 

The  advantage  of  physiologic  treatment  and  training  as  a  preparation 
for  confinement  is  a  matter  which  has  received  increasing  recognition  dui 
ing  the  last  twenty-five  years,  and  has  led  to  so  large  a  number  of  appli- 
cations from  expectant  mothers  that  the  management  found  it  necessary 
to  establish  several  years  ago  a  special  obstetrical  or  lying-in  department. 
This  department  is  in  charge  of  a  physician  who  has  had  exceptional  training 
and  experience  in  this  speciality,  in  one  of  the  largest  lying-in  charities  in 
the  country. 

The  after-treatment  of  these  cases  by  the  Battle  Creek  Sanitarium 
system  is  found  to  be  greatly  conducive  to  rapid  recuperation  and  the 
prevention  of  the  unpleasant  sequelge  which  sometimes  follow  confinement 
under  less  favorable  conditions.  The  classes  of  cases  which  may  be  speci- 
ally benefited  by  this  department  are:  1.  Women  who  are  muscularly  weak 
through  lack  of  original  development  or  sedentary  habits.  Parturition  is 
a  muscular  act,  and  a  good  muscular  development  is  necessary  to  insure 
an  easy  childbirth  and  a  rapid  recovery.  2.  Cases  in  which  obstinate  or 
uncontrollable  vomiting  threatens  an  unfortunate  termination  of  gestation. 
3.  Cases  of  habitual  miscarriage.  4.  Cases  in  which  from  previous  ex- 
perience there  is  apprehension  of  puerperal  eclampsia.  5.  Cases  in  which 
there  is  reason  to  apprehend  abnormalities  of  any  sort  threatening  either 
the  mother  or  the  child. 

The  experience  of  this  department  has  shown  that  the  patient  receives 
very  great  benefit  from  the  special  care  and  treatment,  the  regular  regimen, 


199 


200 


THE    BATTLE    CREEK    SANITARIUM 

the  careful  supervision  of  the  urine,  the  stools,  the  blood-pressure  and  the 
blood,  and  the  carefully  graduated  training  of  the  whole  body  in  prepara- 
tion for  the  final  crisis.  These  benefits  are  shared  by  the  child  as  well  as 
by  the  mother. 

Such  arrangements  are  made  as  permit  the  patient  to  enjoy  all  the 
advantages  of  the  Sanitarium  without  unpleasant  publicity,  and  the  de- 
partment is  supplied  with  every  modern  appliance  and  such  conditions 
as  secure  the  greatest  safety  to  both  mother  and  child. 

The  Kindergarten 

Invalid  mothers  ought  as  a  rule  to  be  completely  relieved  of  the  care  of 
young  children  during  treatment,  but  there  are  exceptional  cases  in  which, 
the  mother  traveling  from  some  far  distant  State  does  not  feel  content  to 
leave  the  little  one  behind.  To  relieve  such  mothers  of  care  and  worry  a 
kindergarten  is  maintained  during  the  summer  months  in  which  children  of 
all  ages  are  entertained  and  instructed.  This  is  not  a  mere  nursery,  but  a 
scientifically  conducted  kindergarten  in  charge  of  a  thoroughly  trained 
and  enthusiastic  kindergartner.  The  work  of  the  kindergarten  is  supple- 
mented by  that  of  competent  nurse-maids,  who  relieve  the  mother  of  all 
cause  of  worry  respecting  her  little  ones.  Infants  and  young  children  are 
not  alloAved  in  the  main  building  except  by  special  arrangement. 

The  Sanitarium  and  Hospital  Training  School  for  Nurses 

The  nurses  employed  in  the  institution  are  students  or  graduates  of  the 
Sanitarium  and  Hospital  Training-school  for  Nurses,  one  of  the  oldest, 
largest,  and  most  thoroughly  equipped  training-schools  for  nurses  in  the 
United  States.  The  school  has  a  faculty  numbering  thirty  capable  teachers 
and  lecturers,  and  a  curriculum  which  covers  not  only  all  the  ground 
ordinarily  covered  in  the  best  hospital  training-schools,  but  in  addition, 
the  great  field  of  hydrotherapy,  electrotherapy,  medical  gymnastics,  photo- 
therapy, medical  dietetics,  and  other  features  of  the  physiologic  system. 

The  nurses  have  on  an  average  two  classes  a  day  during  their 
three  years  period  in  training.  Training  is  carried  forward  during  the 
entire  year,  so  that  the  amount  of  actual  instruction  received  by  the  stud- 
ents of  this  school  is  more  than  double  that  given  in  most  other  training- 
schools. 

The  Battle  Creek  School  of  Health  and  Home  Economics 

The  necessity  for  training  a  large  number  of  cooks,  dietitians,  and  ex- 
pert hygienic  housekeepers  for  the  work  of  the  institution,  to  supply  re- 
cruits for  the  constantly  changing  corps  employed  in  these  capacities, 
often  numbering  a  hundred  or  more,  led  the  management  some  years  ago 
to  establish  a  special  department  for  this  work,  which  has  developed  into  an 
educational  institution  of  unexpected  proportions  and  importance.  This 
department  represents  in  its  curriculum  all  the  branches  usually  taught 
in  the  best  schools  of  domestic  or  household  science,  and  covers  a  still 
broader  field,  especially  in  the  subjects  of  nutrition  and  medical  dietetics, 
and  in  the  application  of  the  latest  findings  of  science  to  the  conduct  of  the 
home  and  the  household. 

201 


CLASS  IN   THE   COOKING   SCHOOL 


DIETITIANS 
202 


THE    BATTLE    CREEK    SANITARIUM 

The  special  advantages  offered  by  this  school  have  already  attracted  a 
considerable  number  of  students  from  distant  parts  of  the  United  tStates 
and  Europe,  including  graduates  from  other  schools,  chietly  persons 
preparing  to  fill  positions  as  teachers  of  home  economics  in  special  schools 
and  other  institutions. 

The  General  Atmosphere 

A  quiet,  unobtrusive  religious  atmosphere  is  maintained  in  the  insti- 
tution. Morning  worship  is  held  daily.  A  Bible  class  for  the  study  of  the 
International  Sunday-school  lesson  is  held  in  the  parlor  Sunday  after- 
noon, and  a  religious  service  is  also  held  in  the  parlor  Sunday  evening. 
A  Christian  Endeavor  Society  meets  every  Friday  evening. 

No  theological  or  sectarian  propaganda  is  permitted.  The  status  of 
the  institution  is  solely  that  of  a  Christian  altruistic  enterprise. 

Large  numbers  of  nurses  (2000),  and  many  physicians  (200),  have  ob- 
tained training  here  for  the  purpose  of  devoting  their  lives  to  various  lines 
of  missionary  and  altruistic  work ;  seventy-five  or  a  himdred  others  are  con- 
stantly under  training  for  this  beneficent  work. 

A  Public   Charity— No  Private   Interest — No   Sectarian 

Affiliation 

The  Battle  Creek  Sanitarium  corporation  is  a  private  enterprise  con- 
ceived and  conducted  solely  for  the  public  welfare.  It  has  never  been 
OAvned  by  any  church  or  sect.  For  many  years  the  institution  was  closely 
affiliated  Avith  the  Seventh-day  Adventist  denomination  because  of  the  fact 
that  the  original  founders  and  contributing  members  were  chiefly  members 
of  the  denomination  named;  but  the  nonsectarian  and  undenominational 
character  of  the  work  was  always  fully  acknowledged,  and  was  fully  indi- 
cated by  its  charter.  An  attempt  made  some  years  ago  by  the  central  com- 
mittee of  the  denomination  named  to  bring  the  institution  under  church 
control  resulted  in  a  complete  severance  of  all  relations  to  that  body,  so  that 
since  that  time  the  institution  has  been  absolutely  free  from  any  sectarian 
alliance  whatever.  The  personnel  is  made  up  of  Christian  men  and  women 
of  various  denominations,  but  there  is  no  church  or  sectarian  control  or 
affiliation. 

There  are  no  stockholders,  no  dividends,  and  no  private  interest;  the 
property  is  dedicated  to  the  public  and  is  held  by  trustees  for  the  purposes 
named  in  the  articles  of  incorporation  (see  pages  25-27). 

An  Allied   Charity 

One  of  the  numerous  allied  charities  worthy  of  notice  is  the  Haskell 
Home  for  Orphans,  organized  through  the  efforts  of  the  Sanitarium 
Management,  aided  chiefly  by  the  generosity  of  Mrs.  Caroline  E.  Haskell, 
of  Michigan  City,  Indiana.  In  this  institution  orphan  children  are  reared, 
trained,  and  educated  in  accordance  with  the  simple  life  principles  of  the 
institution.  More  than  five  hundred  children  have  been  rescued  through 
the  agency  of  the  home. 

This  institution  receives  constant  financial  aid  and  other  essential  assist- 
ance from  the  Sanitarium  Management. 

203 


204 


THE    BATTLE    CREEK    SANITARIUM 

Sanitarium  Health  Foods 

In  the  effort  to  meet  the  dietetic  needs  of  a  great  variety  of  patients, 
the  superintendent  of  the  institution  from  time  to  time  has  devised  various 
foods  and  food  preparations,  some  of  which  have  found  general  popular 
favor.  Among  these  are  cereal  coffee  substitutes,  various  dextrin ized 
and  malted  or  predigested  foods,  and  various  toasted  flaked  cereals.  A 
number  of  these  have  been  widely  exploited  by  various  imitators  and 
piratical  schemers.  The  numerous  varieties  of  wheat  and  corn  flakes  on  the 
market  under  various  picturesque  names  are  all  imitations  of  the  original 
wheat  and  corn  flakes  made  for  the  patients  of  this  institution. 

The  Battle  Creek  Sanitarium  has  never  at  any  time  had  any  con- 
nection whatever  with  the  manufacture  of  any  of  the  numerous  nostrums 
made  or  sold  by  parties  advertising  from  Battle  Creek.  The  prestige  of 
Battle  Creek  as  a  health  center  has  made  this  an  attractive  place  for  the 
operations  of  various  charlatans,  and  not  the  least  pretentious  and  preda- 
tory of  these  are  the  numerous  food  charlatans  who,  posing  as  experts  and 
discoverers,  have  reaped  a  rich  harvest  from  the  credulity  of  a  confiding 
public  and  to  some  extent  at  the  expense  of  the  Battle  Creek  Sanitarium, 
because  the  profession  and  the  public  are  generally  unacquainted  with  the 
facts  above  stated. 

Department  for  the  Treatment   of  Persons  with   Limited  Means 

Provision  is  made  for  the  care  of  the  sick  poor  as  well  as  for  the  well 
to  do.  East  Hall,  one  of  the  large  buildings  not  destroyed  by  the  fire, 
formerly  used  as  a  nurses'  dormitory,  was  immediately  supplied  with  a 
complete  equipment  of  Sanitarium  appliances.  In  this  building  persons 
who  are  not  able  to  pay  the  prices  named  in  the  regular  rate  card  receive 
special  rates  according  as  their  circumstances  may  require.  The  minimum 
rates  in  this  building  are  about  half  the  regular  rates.  Arrangements 
must  be  made  in  advance  for  special  reduced  rates,  as  the  accommodations 
for  this  class  are  necessarily  not  unlimited.  The  winter  season,  when  the 
patronage  is  not  so  large  as  in  the  summer,  is  the  best  time  to  send  patients 
of  this  class.  Worthy  persons  of  limited  means  receive  just  the  same  con- 
sideration as  wealthy  patrons  as  regards  thoroughness  of  examination  and 
treatment. 

Further  provision  is  made  for  persons  whose  means  are  still  more  limited. 
Across  the  road  from  the  main  building  is  located  the  Sanitarium  dispensary. 
Here  are  found  not  only  commodious  examining  offices,  but  also  two  com- 
plete suites  of  treatment  rooms — for  men  and  for  women.  Here  the  poorest 
patient  may  receive  whatever  treatment  his  case  may  require,  without 
paying  anything  either  for  treatment,  medical  attention,  or  examination. 
The  case  of  the  poorest  sufferer  receives  the  same  painstaking,  careful 
investigation  as  that  of  the  wealthiest  patient. 

A  nominal  charge  of  fifty  cents  daily  is  made  for  treatment  in  this  de- 
partment, but  this  is  not  required  of  those  who  are  penniless.  No  appli- 
cant is  turned  away  because  of  his  inability  to  pay. 

This  class  of  patients  are  expected  to  provide  their  own  room  and 
board.  Table  board  prepared  by  Sanitarium  cooks  may  be  had  at  the  rate 
of  fifty  to  seventy-five  cents  a  day  at  the  cafe. 

205 


DISPElS^SARY    AT.  888    THIRTY-FIFTH    PLACE^    CHICAGO 
206 


THE    HA'J'TLE    CREEK    SANITAKIIM 

Several  hundred  patients  aie  now  treated  annually  in  these  departments, 
;and  as  the  debt  incurred  in  tlie  erection  of  the  new  building  is  gradually 
lessened,  the  numl)er  will  ])e  proportionally  increased. 

In  addition  to  the  charitable  work  above  mentioned,  a  large  dispensary 
has  been  maintained  in  Chicago  since  ]893.  This  is  located  in  "The 
Jungle,"  or  stockyard  district,  at  888  Thirty-fifth  Place.  The  Battle  Creek 
Sanitarium  supports  a  number  of  visiting  nurses  in  connection  with  the 
Chicago  dispensary,  as  a  part  of  the  work  of  the  training  school  for  nurses, 
but  the  main  expenses  of  this  institution  are  met  by  personal  donations 
from  the  members  of  the  management.  One  or  more  visiting  nurses  are 
constantly  employed  in  caring  for  the  sick  poor  of  Battle  Creek  and 
vicinity. 

No   Branches   and    No   Affiliated   Institutions 

The  Battle  Creek  Sanitarium  lias  no  branches  and  is  not  allied  to  or 
affiliated  with  any  other  institution  in  the  world.  It  stands  alone  in  its 
work  as  a  separate,  distinct  organization,  having  its  own  mission,  its  own 
Ix)ard  of  management,  and  supported  by  its  o^vn  resources. 

The  Battle  Creek  Sanitarium  is  the  only  institution  which  represents  in 
a  thorough  and  up-to-date  manner  the  Battle  Creek  Sanitarium  System 
of  treatment;  in  fact,  it  is  the  only  one  which  is  authorized  to  announce 
itself  to  the  public  as  employing  the  Battle  Creek  Sanitarium  System,  as 
it  is  the  only  institution  which  is  fitted  up  with  the  necessary  laboratory 
appliances  and  the  trained  corps  of  physicians,  attendants  and  nurses  which 
a  right  application  of  this  system  requires. 

Conclusion 

In  concluding  this  attempt  to  present  on  paper  something  of  an  idea 
of  the  methods  of  dealing  with  sick  people  which  constitute  the  Battle 
Creek  Sanitarium  System  of  Physiological  Therapeutics,  the  writer  desires 
to  express  the  hope  that  he  has  at  least  made  clear  to  the  mind  of  the- 
reader  that  an  earnest  effort  is  made  in  the  work  of  this  institution  to 
represent  the  art  and  science  of  rational  medicine  in  a  worthy  and 
thoroughgoing  manner,  and  to  maintain  the  highest  ethical  and  profes- 
sional ideals. 

As  a  last  word,  the  writer  desires  especially  to  acknowledge  his  in- 
debtedness to  the  members  of  the  profession  of  the  United  States  for 
numberless  personal  courtesies,  and  especially  for  the  increasing  measure  of 
confidence  and  cooperation  shown  toward  the  institution  as  it  has  pro- 
gressed and  developed  since  the  reorganization  when  the  present  manage- 
ment took  charge  thirty-seven  years  ago  (1876),  to  the  present  more  ade- 
quate and  comprehensive  state. 


c:^^ 


// 


•07 


VIEWS  ON  ONE  OF  THE  S ANITA RIU3iI  FARMS 


208 


APPENDIX 


Table  Showing  for  Boys  and  Girls  of  Different  Ages  the  Normal 

Height,  Weight,  Surface,  and  the  Number  op  Food 

Units  or  Calories  Required  Daily 


BOYS 


Age 

5.. 

6.. 

7.. 

8.. 

9.. 
10.. 
11.. 
12.. 
13.. 
14.. 


Age 

5.. 

6.. 

7.. 

8.. 

9.. 
10.. 
11.. 
12.. 


Height  in 

Weight  in 

Surface  in 

Calories  or 

Inches 

Pounds 

Square  Feet 

Food  Units 

41.57 

41.09 

7.9 

816.2 

43.75 

45.17 

8.3 

855 . 9 

45.74 

49.07 

8.8 

912.4 

47.76 

53 .  92 

9.4 

981.1 

49.69 

59.23 

9.9 

1,043.7 

51.58 

65.30 

10.5 

1,117.5 

53.33 

70.18 

11.0 

1,178.2 

55.11 

76.92 

11.6 

1,254.8 

57.21 

84.85 

12.4 

1,352.6 

59.88 

94.91 
GIRLS 

13.4 

1,471.3 

Height  in 

Weight  in 

Surface  in 

Calories  or 

Inches 

Pounds 

Square  Feet 

Food  Units 

41.29 

39.66 

7.7 

784.5 

43.35 

43.28 

8.1 

831.9 

45.52 

47.46 

8.5 

881.7 

47.58 

52.04 

9.2 

957.1 

49 .37 

57.07 

9.7 

1,018.5 

51.34 

62.35 

10.2 

1,081.0 

53.42 

68.84 

10.7 

1,148.5 

55.88 

78.31 

11.8 

1,276.8 

Table  Showing  Height,  Weight,  Surface,  and  Number  of  Food  Units 
or  Calories  Required  Daily  by  Adults 

MEN 


Height 

Weight 

Surface  in 

Calories 

or  Food  Units 

in    In. 

in  Pounds 

Square  Ft. 

Proteins 

Fats 

Carbohydrates 

Total 

61 

131 

15.92 

197 

591 

1,182 

1,970 

62 

133 

16.06 

200 

600 

1,200 

2,000 

63 

136 

16.27 

204 

612 

1,224 

2,040 

64 

140 

16.55 

210 

630 

1,260 

2,100 

65 

143 

16.76 

215 

645 

1,290 

2,150 

66 

147 

17.06 

221 

663 

1,326 

2,210 

67 

152 

17.40 

228 

684 

1,368 

2,280 

68 

157 

17.76 

236 

708 

1,416 

2,360 

69 

162 

18.12 

243 

729 

1,458 

2,430 

70 

167 

18.48 

251 

753 

1,506 

2,510 

71 

173 

18.91 

260 

780 

1,560 

2,600 

72 

179 

19.34 

269 

807 

1,614 

2,690 

73 

185 

19.89 

278 

834 

1,668 

2,780 

74 

192 

20.33 

288 

864 

1,728 

2,880 

75 

200 

20.88 

300 

900 

1,800 

3,000 

209 


THE    BATTLE    CREEK    SANITARIUM 


WOMEN 

Height 

Weight 

Surface  in 

Calories 

or  Food  Units 

in    In. 

in  Pounds 

Square  Ft. 

Proteins 

Fats 

Carbohydrates 

Total 

59 

119 

14.82 

179 

537 

1,074 

1,790 

60 

122 

15.03 

183 

549 

1,098 

1,830 

61 

124 

15.29 

186 

558 

1,116 

1,860 

62 

127 

15.50 

191 

573 

1,146 

1,910 

63 

131 

15.92 

197 

591 

1,182 

1,970 

64 

134 

16.13 

201 

603 

1,206 

2,010 

65 

139 

16.48 

209 

627 

1,254 

2,090 

66 

143 

16.76 

215 

645 

1,290 

2,150 

67 

147 

17.06 

221 

663 

1,326 

2,210 

68 

151 

17.34 

227 

681 

1,362 

2,270 

69 

155 

17.64 

232 

696 

1,392 

2,320 

70 

159 

17.92 

239 

717 

1,434 

2,390 

DIET  TABLE 

Diet  List,  Showing  the  Nutritive  Value  per  Ounce  of  Various  Foodstuffs 
Expressed  in  Calories,  the  Weight  Required  for  a  "Portion"  of  100  Calories 
Each,  and  the  Number  of  Calories  of  Each  Food  Principle  in  an  Ordinary- 
Serving  of  Food. 


Calories  Per  Ounce 


Calories  Served 


a  u  ■■^ 
!=■  °  S 
O 


V4. 

Vs 

1% 
11/2 
51/2 

6 

31/4 
4 

6  i 

31/4 

21/4 

21/2 

51/2 

11/2 

21/2 

3 

6 

2% 

31/2 

51/2 

2% 

31/4 

41/4 

3 

41 

3 

31/0 

6 

1% 

3 

3 

21/2 
4 


Almonds    - 24.5 

Almond    Butter    ..'. 26 

Almond  Cream  1.1 

Almond  Meal 26 

Apples    2.75 

Apples,    AlmioDid    1.01 

Apples,   Baked 6 

Apples,  Baked  wi'th  Meltose 

Dressing    7 

Apples,   Baked   with   Rolled 

Oats    - 1.6 

Apiples,  Baked   Sweet  6 

Apple  Butter   34 

Apple  and  Date  Fluff  3. 

Apples,    Fresh    2.75 

Apple  Fritters   8.65 

Apj)les,    Grape    5 

Apple  and  Jelly  1.63 

Apple   Juice   - 0 

Apple,    Lemon    5 

Apple  Sauee  3 

Apiples,    Sour 18 

Apple  Tapioea  2.6 

Apple  Tart  - 4.76 

Apple,  Whip  or  Snow  5.5 

Apiricots  - - 1.3 

Apricot  a  la  Conda 2.83 

Apricot  Flufe  -     1.6 

Apricot  Sauce  1  2 

Apricot  Shortcake  3.3 

Asparagus   (Cooked)   2.5 

Asparagus  in  Cream  2.8 

Aspiaragus    L/oiaf    4.3 

Asparagus  on  Rice  Biscuit  ..     3.5 
Asparagus  on  Toast 5.5 


146.4 

20.2 

191.1 

.52 

7 

38 

5 

1/2 

152.8 

21.4 

200.2 

.5 

23 

133 

19 

1% 

65.5 

9 

85.8 

1.16 

19 

115 

16 

11-2 

152.8 

21.4 

200.2 

.5 

39 

229.2 

31. G 

^ 

7.15 

91.3 

101.2 

5.5 

2 

7 

91 

1 

5.2 

32.1 

38.2 

2.6 

6 

30 

189 

21/4 

1.3 

28.4 

30.3 

3.3 

2 

3 

94 

1 

1 

35.7 

37.5 

2.66 

3 

4 

143 

iy2 

1.6 

37.7 

40.9 

2.4 

10 

10 

230 

21/, 

1.3 

28.4 

30.3 

3.25 

2 

4 

94 

1 

.88 

18.36 

19.59 

5.1 

1 

3 

46 

% 

7.1 

88.6 

98.8 

1 

7 

18 

225 

21/2 

7.15 

91.3 

101.2 

.98 

2 

1 

91 

1 

44.2 

43.52 

96.3 

1.03 

13 

69 

68 

1V> 

1.3 

45.99 

47.79 

2.1 

1 

4 

120 

11/4 

.98 

38.36 

40.97 

2.45 

5 

3 

117 

11/4 

0 

17 

17 

5.8 

0 

0 

100 

1 

1.3 

34.9 

35.9 

2.8 

1 

4 

95 

1 

.8 

20.65 

21.78 

4.6 

1 

3 

71 

% 

.18 

8.7 

9.6 

11.1 

1 

1 

48 

% 

.66 

36 

39.3 

2.7 

1 

2 

97 

1 

11.19 

41.7 

57.6 

1.7 

14 

33 

128 

1% 

1 

13.9 

22.4 

4.4 

25 

5 

70 

1 

0 

15.6 

16.9 

6 

4 

0 

46 

1/2 

12.38 

19.95 

35.16 

2.77 

15 

60 

100 

1% 

.33 

14.6 

16.5 

6.6 

5 

1 

44 

1/2 

0 

20.5 

21.7 

4.6 

4 

0 

71 

% 

26.8 

24 

54.1 

1.8 

20 

161 

144 

31/4 

8.8 

2.6 

13.9 

7.1 

5 

15 

5 

V4. 

17 

4.9 

24.7 

4 

9 

51 

15 

% 

26.3 

7.6 

38.3 

3.42 

14 

86 

25 

1% 

8.7 

20.9 

3.3 

1.333  7 

19 

49 

% 

26.9 

18.5 

50.9 

1.9 

21 

105 

74 

2 

210 


TI-IE    BATTLE    CREEK    SANITARIUM 


Calories  Per  Ounce  §__;  Calories  Served 


3  Banana    Cream    1.48 

4  Banana  Dessert 2.1 

2  ^  Banana    Fritters    6 

31/2  Banana  Mold  64 

11/4  Banana   Avith  Mayonnaise   ....     3.4 

3  Banana    Snow    1.8 

31/0  Bananas    - 1.5 

21/2  Bananas,    Baked    3.2 

5  Barley,  with  Dates  1.37 

6  Barley    Gruel    1.5 

3y>  Barley,   Pearl   2.97 

43/4  Bean'Brot'h  4.3 

4%  Bean  Broth   (very  thin)   2.8 

3  Bean    Croquettes    8.74 

3%  Beans,    Baked    10. 

31/4  Beans,  Baked   (canned)    8 

4  Bean,  Butter  5.48 

3 1/2  Beans,   Baked   Lima   :...     5 

214  Beans,  Dried  Lima  9.49 

21/4  Beans,  Green  Lima  4.7 

3  Beans,   Hulless   8.3 

31/4  Beans,  Kidney   8.2 

2  §  Beans,  Marbled   Roast   9.7 

2%  Beans,  Navy   (cooked)   -     8.9 

31/4  Beans,   String,  Avith  Butter....     8.2 

3  Beans,  String,  A\dth  Cream  ..     2.34 

4  Beans,   Wax   1.2 

21/4  Bechamel  Sauce  3.02 

2%  Beets    - 2.7 

3  Beet   Greens   2.6 

4  t  Beets  in  Asijie  with  Mayon- 

naise         3.1 

2  Beets,   Buttered   2.61 

21/4  Beets,    Chopped    2.7 

214  Beets,    Sliced    - 2.7 

3  Beets,    Italian 1.83 

114  Biscuit,  Beaten    8.4 

2  Biscuit,  Bran-graham  1.5 

2  \  Biscuit,  Cream  10.3 

1  Biscuit,  Gluten 48.5 

%  Biscuit,  Good  Health    (2) 5.8 

%  Biscuit,  Granose  14.1 

1  Biscuit,  Potato  Gluten  96.8 

1  Biscuit,  Rice  8.5 

1  Biscuit,    Shredded    Wheat 12 

%  Biscuit,  Taro  Gluten  47.8 

3  Blackberries    1.5 

5%  Blackberry    Juice 0 

3  Blackberry    Sauce    8 

31/^  Blanc  Mange,  Chocolate  3.4 

3  Blanc  Mange,  Cocoanut  3.8 

21/^  Blanc  Mange,  Farina  4.16 

5  Blood  Oranges  9 

21/4  Blueberi'ies    .' 7 

51/4  Blueberry  Juice  0 

4%  Blueberry    Sauce    7 

4%  Bouillon,'  Tomato  3.62 

4%  Bouillon,    Vegetable    7 

1/2  Brazil  Nuts 19.8 


10.82 

33.72 

46.02 

2.17 

5 

35 

110 

IV2 

7.4 

23.4 

32.9 

3 

8 

27 

90 

11/4 

27.3 

40.6 

73.93 

1.14 

14 

65 

96 

1% 

.68 

28.4 

29.76 

3.3 

2 

2 

96 

1 

18.3 

26.4 

48.1 

2.6 

3 

19 

28 

% 

.4 

25.4 

27.6 

3 

4 

1 

70 

% 

1.6 

25.7 

28.8 

3.47 

5 

6 

89 

1 

4.73 

32.37 

40.3 

2.5 

8 

11 

81 

1 

1.99 

28.74 

32.1 

3.11 

5 

7 

138 

1% 

.7 

10.2 

12.4 

8.1 

9 

4 

62 

% 

.87 

27.24 

31.08 

3.2 

9 

3 

88 

1 

3.2 

11.6 

19.1 

5.2 

22 

16 

62 

1 

0 

.5 

3.3 

30.2 

14 

0 

2 

i 

11.78 

33.2 

53.72 

1.86 

20 

30 

100 

11/2 

12.5 

33.5 

56 

1.7 

32 

38 

10.5 

1% 

6.6 

22.9 

37.5 

2.6 

27 

22 

76 

iy4 

.8 

17 

23.28 

4.2 

18 

3 

54 

% 

11 

15 

31 

3.22 

17 

35 

48 

1 

1.8 

34.6 

45.9 

2.16 

20 

4 

76 

1 

.8 

17 

22.5 

4.4 

10 

2 

38 

1/7 

.7 

23.7 

32.7 

3 

26 

2 

72 

1 

.5 

21.6 

30.3 

3.3 

27 

1 

72 

1 

2.4 

26.5 

38.6 

2.6 

25 

6 

69 

1 

1.47 

21.38 

30.96 

3.2 

20 

3 

52 

% 

.5 

2L6 

30.3 

3.3 

27 

1 

72 

1 

20.35 

3.15 

25.84 

3.48 

7 

60 

8 

% 

.3 

3.6 

5.1 

19.6 

6 

2 

17 

% 

22.4 

7.8 

33.2 

3 

7 

51 

17 

% 

.3 

8.6 

11.6 

8.6 

5 

1 

19 

y^ 

9.1 

3.7 

15.4 

6.5 

8 

30 

12 

1/2 

10.5 

3.2 

16.8 

5.9 

14 

46 

15 

% 

13.61 

8.9 

24.3 

4 

5 

28 

17 

1/2 

.3 

8.6 

11.6 

8.6 

5 

1 

19 

1/4 

3. 

8.6 

11.6 

8.6 

5 

1 

19 

y* 

17.6 

12.45 

31.8 

3.4 

6 

55 

39 

1 

47.3 

79.2 

134.9 

.75 

10 

61 

104 

1% 

21.4 

17.5 

44.6 

2.3 

15 

46 

39 

1 

27.5 

49.6 

87.5 

1.1 

24 

64 

112 

2 

2.8 

56.1 

107.4 

.93 

45 

3 

52 

1 

2.7 

58.5 

67 

1 

4 

2 

44 

¥2 

1.9 

83.6 

99.6 

1 

10 

1 

64 

% 

16 

22.1 

135 

1 

72 

12 

16 

1 

.9 

96.6 

106 

.94 

7 

1 

92 

1 

3 

85 

100 

1 

12 

3 

85 

1 

32 

68.8 

148 

1 

24 

16 

35 

% 

2.6 

12.7 

16.8 

6 

4 

8 

38 

y2 

0 

30.3 

30.3 

3.3 

0 

0 

174.2 

1% 

3.3 

29.1 

33.3 

3 

2 

10 

88 

1 

22.86 

16.25 

42.52 

2.35 

12 

81 

57 

iy2 

36.4 

17.3 

57.5 

1.74 

11 

111 

53 

1% 

21.56 

18.6 

44.4 

2.26 

13 

73 

64 

1% 

.5 

13.5 

14.9 

6.7 

4 

2 

69 

% 

1.6 

19.4 

21.7 

4.6 

1 

4 

45 

y 

0 

18.9 

1S.9 

5.3 

0 

0 

99.2 

1 

1.6 

14.9 

17.2 

5.8 

3 

7 

65 

% 

7.98 

4.77 

16.37 

6.1 

17 

36 

22 

% 

4.3 

7 

18.3 

5.5 

29 

18 

28 

% 

L78.1 

8.2 

206.1 

.48 

9 

87 

4 

1 

211 


THE    BATTLE    CREEK    SANITARIUM 


d  ^  a; 

;3   O   m 


Calories  Per  Ounce 

Calories 

Served 

O 

"3 

o 

a  a 

'S 
o 

Cm 

c3 

-d  Si 

o 

.2  > 

o  <" 

2.4 

51.2 

60.3 

1.6 

19 

7 

149 

1% 

46.08 

67.24 

122.07 

.81 

23 

133 

194 

31/2 

12.3 

52 

72.8 

1.3 

17 

25 

108 

11/2 

4.7 

63.4 

78.5 

1.27 

20 

8 

122 

11/2 

3.7 

58.1 

72.6 

1.4 

18 

17 

115 

iy2 

4.8 

60.8 

76 

1.3 

20 

9 

121 

11/2 

1.6 

62.1 

74.2 

1.3 

21 

3 

126 

11/2 

3.7 

63.4 

76.4 

1.3 

18 

7 

125 

11/2 

2.4 

58 

71.7 

1.4 

24 

4 

122 

11/2 

6.38 

16.23 

30.5 

3.27 

25 

23 

52 

1 

60.1 

50 

134 

.8 

13 

34 

28 

% 

53.3 

64.8 

134 

.8 

9 

30 

36 

% 

3.16 

11.58 

19.13 

5.2 

22 

16 

62 

1 

3.3 

4.7 

11.7 

8.5 

16 

14 

20 

V2 

.9 

2.9 

7 

14.2 

11 

3 

11 

VAt 

0 

.5 

3.3 

30.3 

13.3 

0 

2.4 

i 

9.4 

47 

58.5 

1.7 

7 

31 

162 

2 

30.7 

3.9 

36.1 

2.76 

3 

64 

8 

% 

32.65 

13 

53 

1.88 

18 

76 

31 

1% 

17.3 

66.8 

91.4 

1.1 

10 

24 

91 

IV4. 

19.2 

69.2 

100 

1 

13 

23 

89 

m 

20.2 

68.2 

96.3 

1.03 

10 

26 

89 

1V4. 

16.3 

60.4 

90 

1.1 

18 

22 

85 

ly* 

198 

0 

200 

.2 

1 

99 

0 

1 

1.3 

5.6 

10.4 

9.6 

25 

10 

40 

% 

10.26 

4.1 

18.56 

5.3 

12 

26 

12 

1/2 

2.38 

3.39 

6.95 

14.4 

4 

9 

12 

V4 

6.1 

1.9 

5.7 

4.3 

3 

14 

8 

1/4 

8.1 

3.7 

13.3 

7.5 

5 

31 

14 

1/2 

15.5 

9.3 

27.3 

3 

8 

42 

25 

% 

3 

1.9 

5.7 

17.5 

3 

14 

8 

V4: 

40.9 

66.8 

114.6 

.87 

15 

80 

130 

21/4 

28.5 

88.6 

138.13 

.72 

42 

57 

176 

2% 

0 

94.8 

100.4 

1 

6 

0 

94 

1 

3.8 

85.2 

90 

1.1 

1 

5 

94 

1 

10.9 

11.6 

8.6 

5 

70 

% 

0 

3.1 

3.3 

30.3 

1 

1 

8 

A 

11.4 

23.6 

40.2 

2.4 

16 

36 

73 

11/4 

7.5 

10.3 

19.8 

5.05 

7 

29 

39 

% 

14.48 

9.39 

24.9 

4.3 

4 

58 

38 

1 

17.28 

10.9 

29.5 

3.38 

3 

44 

28 

% 

125.7 

28.24 

182.81 

.54 

15 

70 

15 

1 

7.64 

68.9 

78-.5 

1.2 

2 

7 

66 

% 

31.4 

6 

41.6 

2.6 

13 

94 

18 

iy4 

30.5 

3 

34.7 

2.88 

2 

90 

8 

1 

15.7 

6.4 

24.1 

3.8 

7 

48 

20 

% 

3.9 

3 

7.9 

12.6 

3 

13 

9 

y4 

.3 

3.9 

5.5 

18.1 

1 

5 

^ 

11.9 

4.6 

18.5 

4.2 

8 

48 

19 

% 

9.9 

9.8 

23 

4.8 

12 

32 

31 

% 

6.87 

3.92 

11.83 

8.5 

5 

29 

16 

V2 

29.8 

22.7 

61.9 

1.6 

23 

73 

54 

iy2 

12.4 

5.1 

37.3 

2.6 

40 

25 

10 

% 

64.5 

9.1 

85.6 

1.1 

21 

113 

16 

iy2 

82.8 

3.9 

106.9 

.9 

10 

38 

2 

V2 

2.2 

19.5 

22.8 

4.4 

3 

5 

42 

V2 

2.2 

19.5 

22.8 

4.4 

4 

8 

63 

% 

2 

29.4 

32.6 

3 

4 

6 

90 

1 

3       Bread,  Boston  Brown  6.5 

3       Bread  Onstard  Pudding  8.75 

2       Bread,   Corn   -     8.5 

2       Bread,  Fruit  - - 10.4 

2       Bread,    Gluten    10.8 

2       Bread,    G-rabam 10.4 

2       Bread,  Eye   10.5 

2       Bread,  White   9.3 

2  Bread,  Whole  Wheat   11.3 

1       Breakfast   Pickup    7.91 

3-5    Bromose,  Nut  23 

3-5    Bromose,   Fig   15.7 

4%  Broth,   Bean 4.39 

4%  Broth   (Moek  Chicken)   3.7 

4%  Broth,  Protose  3.2 

4%  Broth    (Vegetable)    2.8 

31/2  Brown    Betty    2.1 

2%  Brown   Gravy   1.5 

214  Browned  Cream  Gravy  7.4 

114  Buns     - 7.3 

11/4  Buns,    Cinnamon    10.9 

lYi  Buns,    Fruit    7.9 

1  i  Buns    (Nut)    13.3 

V2  Butter    (Dairy)    2 

6       Buttermilk     3.5 

3  Cabbage,  Baked  -     4.2 

3y2   Cabbage,  Baked  in  Tomato  ..     1.18 

4  Cabbage,  Boiled  8 

3%  Cabbage,  Creamed  1.5 

3  Cabbage,    Escalloped    2.75 

4  Cabbage,    Steamed    8 

2  Cake,   Coffee 7.6 

2  Cake,  Eice   Griddle  21 

1       Candy  (Malt  Honey  Car- 
amels)         5.6 

1       Candy    (Sanitas  Ohocolates)..     1 

6f     Canteloupe    7 

4       Caramel    Cereal    2 

3  Caramel   Custard    5.22 

3%  Carrots,  Creamed  2.01 

3       CaiTots,  Italian   1.07 

3       Carrots,    Mashed    .- 1.38 

ya   Cashew   Nuts    28.87 

1       Catsup,    Grape   2.66 

3       CauUfiower  au  Gratin  4.2 

3       CauKflower,   Buttered   1.2 

3       Cauliflower,    Creamed 2.5 

3       Cauliflower,    Steamed    1 

1  Celery 1.3 

41/4   Celery,    Creamed    - 1.9 

3%   Celery   and   Peas   3.3 

414  Celery,   Stewed  - 1 

2%  Cereal  Eoast  - 9.4 

2  Cheese,   Cottage  19.9 

1%  Cheese   Croquettes   12 

%  Cheese,    Yogurt    20.3 

2%  Cherries     1.2 

31/4  Cherries,   White   1.2 

3  Cherry   Sauce   1.2 


212 


TPIE    BATTLE    CREEK    SANITARIUM 


3    O    M 

o 


Calories  Per  Ounce 


>i  09 


o  m 

«  CO        c 


Calories  Served 


.2  > 


27.97  49.16 

21.4  47.3 

24.3  60.4 

16.2  60.1 

2.6  28.26 


4  Cherry   Pie   7.83 

21/^  Chestnut    Roast    9.94 

2%  Chestnuts,  Creamed  9.49 

2%  Chestnuts  and  Tomiato  Sauce     9.2 
1%   Chili  Sauce   4.91 

5  Cocoa,  Sanitas  Health  (with- 

out   sugar)    2.6  17.7 

2  Cocoanuts    6.6  134.9 

21/^  Cornlet     3.7  2^9 

3  Cornlet  au  Gi'atin  4.16  21.5 

3       Corn,  Baked   8.5  22.12 

3       Corn    Cake    13.9  28.8 

3       Corn,   Creamed  3.8  6 

%  Corn   Flakes   10.8  1.4 

2%  Corn,  Green  Sweet    (Cooked)      3.6  2.9 

414  Corn,  Hulled  2.6  .5 

2       Corn    Pone 8  32.1 

21/^  Corn  Pulp  3.7  2.9 

2%  Corn  Roast   7.5  21.31 

2  Cottage    Cheese    19.87  12.4 

1       Crackers,    Fruit   : 13.2  27.2 

1       Crackers,   Graham    11. 7  25.1 

1'      Ci-ackers,  Oatmeal  13.3  29.6 

1  Crackers,  Whole  Wheat   11.4  26 

3  Cranberries    (Cooked)     2  .7 

2  Cranberry  Jelly 4  i 

2%  Cream    2.9  49.3 

2       Cream  Molds 14.4  24.5 

1  Cream   Sticks 10.9  9.9 

21/4  Cream    Sauce 3.7  22.9 

314  Cream  of  Wheat 1.7  A 

6       Cream  Yogurt  Whey  1.4  8.8 

%  Crisps,    Cocoanut   .."-. 9.3  52 

21/^  Crust,    Shortcake 94  12.6 

5       Crust,  Single  Pie  26.7  44.9 

2  Cucumbers 9  .5 

3  Cucumber   Jelly .5  .3 

3%  Cucumber,    Stuffed    1.68  7.5 

3       Currents,  Red 1.8 

1  (Jurrant   Jelly 1.2 

3       Custard,  Bread  Pudding   8.75  46.08 

3       Custard,    Caramel    5.2  11.4 

4%   Custard,   Plain 5.6  13 

2%  Custard,   Tapioca  4.5  17.6 

3       Cutlets,   Macaroni 13.82  28.49 

214   Cutlets,  Nut   22.95  23.3 

2%  Cutlets,  Nuttolene 16.27  32.66 

2  Cutlets,    Protose 21.5  19.4 

3  Dandelion   Greens    (Cooked)..     2.8  2.7 

4  Dasheen 7.3  .15 

4%  Dasheen,   Escalloped 5.55  14.07 

3%  Dasheen  Shoots  with  Vege- 
table Sauce  5.28 

31/2  Dasheen   Shoots,    Creamed 6.1  34.26     7.52 

2       Date   Marmalade   1.75  14.5     62.6 

5%  Date  Pumpkin  Pie   7  24.1     26 

1%  Dates     2.5  7.5     91.5 

2   Dates  Stuffed 4.6  27.7  82.4 


84.96 

78.6 

94.3 

85.5 

35.8 


4.24 
32.5 
23.2 
22.9 
20.8 
52.8 
16.8 
91.3 
22 
20.7 
68.3 
23.2 
24.15 

5.1 
72.6 
86.1 
80.5 
84.5 
47.8 
49.7 
5.3 
83.5 

89 
9 

12.1 
5.7 

64 
2.7 

42.2 
3.6 
3 

10.2 

14.9 

90.1 

67.24 

23.6 

10.4 

26.4 

32.35 

15.26 

13.58 

17.3 

12.5 

73.5 

39.71 


24.6 
174 
29.8 
48.6 
51.4 
95.6 
26.6 

103.5 
28.5 
23.8 

108.4 
29.8 
52.96 
37.36 

113.1 

122.9 

123.8 

121.9 
48.7 
51.1 
57.5 

117.4 

100 
35.6 
14.2 
16 

125.4 

16.24 
113.8 
5 
3.8 

20.4 
16.7 

91.3 
122.07 

40.2 

29.13 

48.3 

74.6 

61.5 

62.5 

61.2 

18 

80.9 

59.33 


1.2 
1.27 
1.1 
1.2 

2.7 

4.1 

.6 
3.3 
2 
2 
1 
3.7 

.97 
3.5 
4.2 

.92 
3.3 
1.8 
2.6 

.9 


2.1 
1.9 
1.7 


30 
26 

27 
30 

7 

13 

13, 

9 

13 

25 

42 

11 

7 

10 

11 

11 

9 

22 

40 

12 

12 

14 

12 

1 

1 


.8  27 


.99 

2.8 

7 

6.2 


5    5 

.87  117 

20    2 

26.3   1 

4.89  6 

6 

1.09 
.81 

2.4 

5 

2.1 

1.3 

1.6 

1.6 

1.6 

5.5 

1.2 

1.7 


5 
1 
23 
16 
23 
12 
41 
56 
40 
50 
8 
13 
25 


18.24  5.84  29.96  3.5  15 


47.95 

78.9 

57.1 

101.5 

114.7 


2  25 

1.3  3 

1.75  36 

1  3 

.87  9 


100 

54 

65 

50 

3 

89 
2  269.; 
7 
66 
64 
90 
17 
1 
7 
2 
59 
7 
60 
25 
22 
25 
30 
27 
2 
2 
107 
53 
1 
50 
2 
55 
!  41 
35 
197 
1 
0 
31 
0 

133 
36 

57 
45 
86 
57 
80 
40 

8 

1 
75 

65 
120 

28 
126 

12 

54 


195 
120 
158 
170 
40 

23 
65 
59 
71 
61 

168 
47 
67 
58 
87 

130 
59 
68 
10 
66 
88 
81 
86 

147 
97 
12 

195 
44 
18 

42 

36 

51 

10 

186 

7 

9 

38 

45 

99 
194 

73 

45 

68 

98 

37 

30 

35 

34 
136 
150 

20 

30 
119 
138 
160 
162 


31/4 
2 

21/2 
21/2 

11/4 

3y2 
% 

11/2 

3 
% 
% 
% 

1 

2 
% 

11/2 
% 

1 

1% 
11/4 
11/4 
11/2 
1 

11/4 
2% 
1/2 
% 
1/2 
1 
1 
1/2 
5 

^^ 
1 

TIF 

% 

1/2 
1 
31/0 

iy4 
11/4 
11/4 
21/4 
11/2 
11/0 

11/4 

1/2 

11/2 

21/2 

1 

1% 
11/2 
3 
1% 

21/4 


213 


THE    BATTLE    CREEK    SANITARIUM 


fj     fH     O 

d  o  « 
O 


Calorie 

s  Per  ( 

3unce 

.-pTi 

Calories 

Served 

>,  to 

O 

o 

to   ftO 

"  <a  i-i 

^  a 

"3 
p 

.2  > 

P4 

7.1  ■ 

88.6 

98.8 

1 

7 

18 

225 

2% 

1.3 

45.9 

47.7 

2.1 

1 

4 

120 

iy+ 

.98 

38.3 

40.9 

2.45 

5 

3 

117 

1V4 

1.3 

34.9 

35.89 

2.8 

1 

4 

95 

1 

11.19 

41.7 

57.6 

1.7 

14 

33 

128 

1% 

1 

13.9 

22.4 

4.4 

25 

5 

70 

1 

.33 

14.6 

16.5 

6.6 

5 

1 

44 

v> 

7.4 

23.4 

32.6 

3 

8 

27 

90 

1V4 

.68 

28.4 

29.76 

3.3 

2 

2 

93 

1 

A 

25.4 

27.6 

3 

4 

1 

70 

% 

32.37 

79.93 

117.60 

.8 

15 

110, 

275 

4 

27.65 

63.70 

98.59 

2 

14 

56 

130 

2 

26 

76.3 

109.9 

9.9 

13 

47 

240 

3 

34.6 

83.2 

127.1 

.76 

18 

68 

164 

21A 

24 

74.9 

105.7 

.9 

13.6 

48 

149.8 

2t^it 

9.4 

85.2 

100.4 

1 

17.4 

28.2 

255.6 

3 

45.9 

76.5 

130.6 

.7 

20 

115 

190 

31/4 

3.9  : 

120.4 

131.1 

7.6 

17 

8 

300 

3% 

30.4 

59.4 

95.7 

1 

10 

71 

144 

2% 

35.2 

67.1 

111.4 

.9 

18 

71 

136 

2V4 

58.8 

56 

128.5 

.7 

24 

103 

98 

21/+ 

27.1 

65.6 

97.1 

.1 

4 

35 

86 

11/4 

15.6 

66.9 

91 

1.09 

13 

26 

111 

IV. 

28.91 

75.91 

112.24 

.8 

15 

58 

152 

21/4 

23.9 

175.9 

216.8 

.4 

22 

100 

228 

3i/> 

14.2 

94.2 

120.8 

.8 

20 

23 

157 

2 

55.52 

90.13 

156.2 

.64 

20 

107 

173 

3 

45.8 

59.5 

115.5 

.86 

19 

90 

116 

21/4 

.31 

26.5 

29.1 

3.4 

5 

1 

69 

% 

25.77 

43.77 

74.1 

1.3 

11 

61 

103 

1% 

22.4 

65.9 

96 

1 

16 

46 

138 

2 

39 

39.3 

85 

.1 

16 

79 

80 

1% 

31 

35.5 

2 

17 

62 

71 

3 

1% 

43.6 

30.3 

83.2 

1.2 

28 

131 

91 

2% 

14  9 

10.1 

43.5 

2.2 

63 

52 

35 

iv-> 

25.3 

12.3 

43.2 

2.3 

17 

71 

37 

IV4 

22.1 

18.1 

45.6 

2.2 

18 

72 

60 

liA 

17.57 

26.44 

48.3 

2 

12 

45 

68 

IV4 

12.23 

20.9 

36 

2.9 

6 

35 

59 

1 

.88 

29.45 

30.7 

3.2 

1 

2 

97 

1 

9.4 

23.3 

36.4 

2.74 

10 

27 

63 

1 

0 

23.4 

24.12 

4 

4 

0 

96 

1 

31.48 

24.6 

28.12 

3.5 

2 

13 

85 

1 

0 

15.14 

15.14 

.6 

0 

0 

50 

lA 

0 

11.5 

11.5 

8.7 

0 

0 

50 

y-. 

12.67 

67.8 

134.5 

.7   '. 

134 

29 

162 

31/4 

0 

6.6 

6.6 

6 

0 

0 

50 

v. 

125.7 

28.2 

182 

.54 

15 

70 

15 

1 

5.6 

44 

55.4 

.1 

13 

132 

105 

2% 

.   9.7 

1.2 

12.4 

.8 

6 

39 

5 

% 

.06 

25.79 

27.63 

3.61 

5 

1 

69 

% 

55.9 

65.4 

129.4 

.7 

14 

86 

100 

2 

21.68 

39.34 

65.35 

1.5 

13 

66 

121 

2 

4.26 

27.2 

32.14 

3 

5 

21 

124 

11/7 

7.2 

91.34 

101.2 

.9 

7 

20 

273 

3 

12.6 

31.1 

47.4 

2.1 

15 

53 

132 

2 

2.5 

37.2 

41.4 

.2 

10 

15 

150 

1% 

DESSEETkS— 

2%  Apple  and  Date  Fluff 3 

214  Apple,   Grape   .-.- 5 

3       Apple  and  Jelly 1.63 

2%  Apple  Lemon   5 

314  Apple  Tai-t   .- 4.76 

414   Apple  Whip  or  Snow  — .     5.5 

3  '  Apricot  Fluff 1.6 

4  Banana  Dessert   2.1 

31/2  Banana  Mold   64 

3       Banana  Snow  1.8 

31/2  Cake,  Apple   Sauce   5.33 

2       Oake,    Cream 7.22 

2       Cake,  Cinnamon  7.6 

2       Cake,    Delicate    9.2 

2  Cake,  Frosted  6.8 

3  Cake,  Jelly  Roll  ....: 5.8 

21/2   Cake,   Layer   8.2 

2%  Cake,    Leather 6.8 

2%  Cake,  Light  Fruit 5.8 

2  -    Cake,  Nut  9.1 

1%  Cake,  Nut  Sponge  13.7 

1  §  Cake,  Molasses  4.3 

1  f  Cage,   Orange   7.8 

2  Cake,  One  Egg  7.42 

314  Cake,  Rocksberry 7.9 

11/2   Cake,   Sponge   12.4 

2       Oake,   Wihite   10.58 

2  Cake,  Whole 9.9 

3  Compote  of  Fruit  with  Rice...      2.27 
%  Cookies 4.65 

2       Cookies,    Molasses    7.7 

2  Cracker  Crusit 6.6 

3  Cream,   Lemon   8.5 

3       Cream  Puffs 9.3 

314   Custiard  Cheese  18.5 

3       Custard    Cocoanut    5.6 

314  Custard,    Cup    5.4 

2%  Custard,   Tiapioea  4.53 

3       Date    Surprise    3 

3%  Frozen   Peaches   27 

3  Indian    Trifle 3.64 

4  Jellied    Apricot    .63 

31/0  Jellied  Peach   58 

3  S  Jelly,  Cider 0 

4  Jelly,  Red  Raspberry  0 

2%  Jelly   Roll   54.7 

3       Jelley,  Strawberry  0 

■    %  Nuts,   Cashew 28.8 

1       Nuts  and  Raisins  5.8 

1/4  Nuts,   Pistachio    1.5 

3        Orange  Fluff  1.77 

1%  Parisian  Sweets  ■. 8.1 

3       Peach   Co^bbler 4.33 

414  Pears,   Baked   68 

3  Pie,  Apple  and  Date  2.6 

41^4  Pie,  Banana,  Raw  3.7 

4  Pie,  Banana  and  Raisin,  raw     1.5 
4  1  Pie,   Pineapple   6.08     11.4     34.5       52  1.9     26       49      150      2% 


214 


THE    BATTLE    CREEK    SANITARHM 


Calories  Per  Ounce  =_.  Calories  Served 


;3  O 

o 


(S 

o 

'o 

5°° 

c  "' 

21.4 

37.4 

66.6 

4.5 

46 

129 

225 

4 

29.7 

40.7 

83.2 

1.23 

49 

117 

159 

3y4 

33.9 

87.6 

127.8 

7 

6 

33 

86 

11/4 

17.3 

31 

56.2 

1.8 

20 

46 

84 

1% 

10.6 

59.9 

75.7 

1.3 

15 

29 

156 

2 

29.09 

36.3 

69.6 

1.4 

12 

73 

90 

1% 

32.3 

61  2 

104.5 

.9 

13 

64 

123 

2 

.5 

70 

71.27 

.69 

1 

1 

223 

2V4 

8.7 

23.7 

33.3 

2 

5 

26 

69 

1 

.2 

38.6 

41.6 

2.4 

9 

1 

115 

IV4 

46.08 

67.2 

122.08 

.81 

23 

133 

194 

31A 

25.9 

65.7 

97.4 

1 

15 

67 

168 

2V> 

9.5 

29.7 

43.4 

2.4 

8 

22 

70 

1 

127.6 

53.1 

70.3 

1.42 

15 

47 

187 

2  V',. 

9.06 

59.69 

74.9 

1.3 

17 

24 

159 

2 

26.5 

46.1 

80.9 

1.2 

20 

66 

114 

2 

1.83 

52.75 

54.82 

1.52 

3 

29 

193 

21/4 

7.5 

74.6 

88.7 

1.1 

15 

17 

168 

2 

15.96 

45.2 

70.5 

1.4 

13 

48 

139 

2 

7.1 

28.49 

38.78 

2.5 

12 

26 

87 

11/4 

13.7 

29.2 

44 

2.5 

4 

47 

99 

IV?. 

5.9 

30.9 

39.3 

2.5 

6 

15 

79 

1 

23.1 

32.2 

63.7 

1.57 

26 

72 

102 

2 

6 

80.2 

91.5 

1 

10 

12 

153 

1% 

17.5 

26.4 

78.4 

2 

12 

45 

68 

1V+ 

23.11 

63.19 

90.4 

1.10 

13 

71 

191 

2% 

19 

80.4 

105.6 

.9 

17 

54 

229 

3 

36 

58 

101 

.9 

20 

107 

173 

3 

.6 

17.6 

18.8 

5.2 

4 

4 

67 

% 

6.4 

36.5 

45.2 

2.3 

7 

23 

145 

1% 

.3 

32.4 

35 

2.8 

6 

1 

68 

% 

0  3036.7  3036.7 

.03 

0 

0 

100 

1 

14.6 

24.8 

40.36 

2.4 

2 

45 

78 

IV4 

7.4 

32.8 

42.7 

2.3 

9 

26 

115 

IV, 

28.8 

27.6 

55.6 

.17 

5 

132 

138 

2% 

29.39 

18.7 

29.5 

2 

7 

148 

95 

2V, 

1.7 

33.4 

41.7 

2.3 

23 

60 

117 

2 

52 

54 

125.4 

.8 

8 

41 

51 

1 

11.8 

28.6 

42.2 

2.3 

10 

41 

99 

IV 

.5 

7.5 

13.5 

7.4 

22 

2 

26 

V, 

.4 

17.5 

18.2 

15.4 

1 

1 

48 

% 

14.5 

63 

82.9 

1.2 

16 

45 

189 

2V. 

25.7 

43.7 

74.1 

1.3 

5 

26 

44 

% 

6.1 

15.9 

24.2 

4.1 

10 

25 

65 

1 

18.37 

24.82 

48.22 

2.07 

11 

38 

51 

1 

20.7 

9.34 

35.5 

2.8 

15 

59 

26 

1 

30.66 

1.46 

44.49 

2.25 

30 

69 

1 

1 

35.2 

35.3 

77.6 

1.28 

25 

125 

125 

2% 

28.3 

33.5 

68.4 

1.46 

19 

81 

100 

2 

22.7 

8 

35.5 

2.82 

10 

47 

18 

% 

56.8 

1.1 

68.5 

1.8 

43 

128 

4 

1% 

66.5 

2.6 

96.9 

1 

28 

69 

3 

1 

29.6 

30.8 

73.4 

1.7 

43 

101 

106 

21/, 

15.1 

10.21 

34.3 

2.9 

40 

65 

45 

IVo 

44.1 

13.8 

67.06 

1.5 

24 

116 

35 

1% 

32 

0 

48.3 

2.1 

29 

46 

0 

% 

32 

0 

48.3 

2.1 

29 

46 

0 

% 

22.5 

35.5 

75 

1.3 

34 

45 

71 

IV, 

17.6 

38.8 

70 

1.4 

34 

44 

97 

1% 

18.28 

25.36 

57.76 

1.7 

36 

47 

67 

11/0 

6  Pie,  Sweet  Potato  7.76 

4  Pie,  Vanilla  Cream  12.7 

3  Pineapple  Oream  Dessert 6.09 

21/^  Pineapple  Popovers  7.8 

21/0  Pineapple  Eoll   5.2 

2Vi  Pineapple   Bread   4.6 

2%  Pineapple   Sponge   7.9 

21/4  Pineapple  Tapioca  36 

3  Prune  Fliifif  1.5 

3  Prune  Souffle  3 

3  Pudding,  Bread  Oustard 8.7 

21/2  Pudding,  Cabinet 5.7 

2V2  Pudding,  Caramel  Cornstarch     4.1 

3i/>  Pudding,    Steamed   Cranberry     4.4 

2%  Pudding,  Christmas  "..     6.21 

21/2  Pudding,  Cottage  8.2 

3%  Pudding,   Fig  Tapiooa  2 

21/4  Pudding,  Graham  Q.Q 

3  Pudding,  Log  Cabin  4.34 

3  Pudding,  Orange  3.17 

3  Pudding,  Pineapple  1.04 

21/4  Pudding,  Pressed  Fruit  2.4 

?>Vi  Pudding,  Queen 8.4 

2  Pudding,  Eice  5.2 

2Vi  Pudding,  Tapioca  Custard  ....     4.5 

3  Pudding,   Steamed  Fruit 4.1 

3    •  Pudding,   St.   James   6.2 

3  Pudding,  Vevey  7 

3%  Raspberry  and  Banana  Mould'      .6 

4  Rice  and  Banana  2.3 

2  Rice  with  Cream  Fluff  2.3 

31/2  Salpieon  Fruit   0 

31/8  Sherbet  Grape    86 

31/2  Sherbet  Milk  2.5 

5  Shortcake,   Pineapple   1.19 

5  Shortcake,  Orange  1.3 

3%  ShoTtcake,  Strawberry  6.5 

%  Sticks,  Cocoanut -..    9.3 

3i  Strawberry  Dessert  3 

414  Strawberry  Whip 5.4 

3  Strawberry  and  Banana  Jelly       .33 
2%  Stuffed  Figs 5.4 

%  Vanilla  Wafers  4.6 

4  Yogurt  Ice  Cream  2.2 

2  Dressing  foT  Jioast  .-     5.03 

3  Egg  Macaroni ..     5.44 

21/4  Egg  Mayonnaise  Salad  13.37 

3%  Egg  Plant  Creamed 7.1 

3  Egg  plant  baked  6.57 

2%  Egg   Sauce 4.8 

21/4  Eggs  Alpine  10.6 

214  Eggs  baked  in  cream  27.7 

3%  Eggs  Boiled  in  Canapes 13 

4  h  Eggs,  Breaded 9.11 

21/2  Eggs   Eisoalloped    9.16 

11/4  Eggs,  Hard  Jellied 16.3 

11/4  Eggs,   Poached   16.3 

2  Eggs  Poached  in  Corn  Flakes  17 

2%  Eggs  Poached  on  Rice  Biscuits  13.6 

21/2  Eggs,  Poached,  on  Toast  14.1 


215 


THE    BATTLE    CREEK    SANITARIUM 


Calories  Per  Ounce  g   .  Calories  Served 


m  d.9  9  -=!«  "J  P.O      g  ,rt« 

3  o  M  ^H  ts         la's  -g  E3  S'lH       fH  OS  os'o 

O  fLiERO^O°PMfeO 

2  Eggs,    Scrambled     14.1       23.7       1.45     39.25     2.5     28        45  2 

3%  Eggs  and  Onions  in  White 

Sauoe   4.07 

3  Eggs  Scrambled  on  Toast 12.3 

IVi  Eggs,  Soft  Jellied  16.3 

2  H  Eggs,    Spanish    9.1 

4  Egg  Timbale  Eev 8.23 

4  Egg    Timbales    9.3 

11/2  Egg  Yolks  Hard  Boiled  (2)..  21.6 

31/^  Esoarole   Creamed   5.42 

3  i  Eggnog,    Foamy    8.8 

21/2  Eggnog,  Lemon  Flavor  12.4 

8       Eggnog,    Milk    5.9 

3       Endive     3.3 

y-,  English  Walnnts   19.4 

31/2  Farina    - 2.6 

2V2  Fig  Marmalade   - 2.8 

2%  Fig    Pudding 4.7 

2       Fiigs    5 

2  Figs,    Steamed    4.6 

3  Figs,    Stewed    -- 2.3 

1/2  Filberts    18.2 

3  Floating  Island   - - 5.45 

14  French  Salad,  Dressing 0 

4  Frozen  Malted  Nuts  ..- 9.2 

31/8   Fruit    Gelee    1.10 

6       Fruit  Nectar 0 

2  Gems,    Corn    9 

31/.  Gems,    Nut    -- 10.1 

SVi  Gems,   Wheat   - 10 

1  Gluten   Biscuit,    40%    48.5 

1/2  Gluten  Biscuit,  80  %  88.5 

51/2  Gluten    Mush    3.2 

4  Gluten  Mush,  Cream  5.5 

%  Golden   Dressing    4 

5  Good  Health  Breakfast  Food     1.5 

2%  Gooseberries,    Stewed    5 

5%  Graham    Grits    2.1 

414  Graham  Mush  2.6 

5  Graham  Mush  wTith  Dates  .--  2.2 
41/0  Grains  of  Gold   (Cooked)    ....     1.7 

114  Granola --  15.6 

414  Granola   Date  Mush   3 

4%  Granola  Fruit  Mush 3.1 

41/2  Granola    Mush 4.3 

%  Granose  Biscuit   14.1 

%  Granose   Flakes    13.4 

3%  Grape   Fruit   - 9 

6  Grape   Juice   -     0 

5  Grapes    (Atwater)     1.16 

3  Grapes,    Cooked 88 

1%   Granuto      19.1 

1       Gravy,  Brown  Nut   7.8 

1%  Gravy,   Creamed  Gluten  4.3 

6  Gruel,  Baked  Potato  7 

5  Gruel,  Baked  Potato   Cream..     1.8 

6  Gruel,  Barley   1.4S 

6%  Gruel,  Corn  Flakes  -.. 7 

614  Gruel,  Corn  Meal 8 

216 


18.89 

10.14 

33.11 

3 

16 

69 

40 

11/4 

16.3 

21.4 

50 

2 

37 

49 

64 

11/2 

32 

0 

48.3 

2.1 

29 

46 

0 

% 

31.3 

3.04 

43.47 

2.33 

21 

72 

7 

1 

18.4 

3.7 

3.2 

30.33 

34 

76 

15 

m 

30.2 

4.1 

43.5 

2.4 

38 

120 

17 

1% 

82.6 

0 

102.2 

95 

20 

80 

0 

1 

9.21 

8.65 

23.28 

4.6 

17 

30 

28 

% 

27.6 

14.2 

50.4 

2 

31 

93 

51 

1% 

.5 

25.6 

38.5 

2.5 

32 

2 

66 

1 

23 

9 

38 

2.6 

46 

183 

71 

3 

1 

4.93 

9.3 

10.7 

9 

3 

13 

1/4 

169.2 

18.2 

206.8 

.47 

9 

82 

9 

1 

.8 

18 

21.4 

4.7 

9.1 

2.8 

63 

% 

.4 

48.7 

57.9 

1.9 

6 

1 

118 

11/4 

15.3 

34.7 

■  54.7 

1.83 

12 

42 

96 

IV, 

8 

79.7 

83.5 

1.2 

5 

1 

144 

11/2 

.6 

73.9 

79.1 

1 

9 

1 

140 

iy2 

.4 

49.4 

52.1 

1.92 

6 

1 

143 

iy2 

174.1 

15.2 

207.5 

.48 

9 

84 

7 

1 

12.4 

21.6 

39.6 

2.5 

17 

62 

71 

iy2 

198 

2.85 

200.9 

.5 

0 

99 

1 

1 

24.5 

17 

70.7 

2 

36 

96 

68 

2 

.5 

38.1 

39.7 

2.5 

3 

2 

120 

iy4 

0 

11.6 

11.6 

7 

0 

0 

75 

% 

22.2 

21.7 

72.1 

1.3 

20 

56 

84 

ly 

37.2 

46.8 

94 

1 

35 

129 

161 

3y4 

26.1 

48.4 

84.5 

1.18 

33 

86 

156 

1% 

2.8 

56.1 

107.4 

.9 

45 

3 

52 

1 

2.7 

21 

111.9 

.9 

41 

1 

8 

y 

.3 

14.68 

8.2 

5.4 

18 

1 

81 

1 

27 

16.5 

49 

2.5 

22 

111 

67 

2 

8.5 

45 

57.5 

1.72 

3 

8 

39 

y 

1.2 

9 

11.7 

3.50 

8 

7 

35 

% 

18.9 

19.4 

5.15 

1 

49 

y 

.3 

14.9 

17.3 

5.8 

12 

2 

86 

1 

.99 

4 

17.6 

5.7 

11 

4 

60 

% 

1.6 

21.5 

25.1 

4 

10 

10 

105 

iy4 

.4 

14.5 

16.6 

6 

7 

2 

66 

% 

1.1 

85 

101.7 

.98 

19 

1 

105 

iy4 

1 

25.2 

29.2 

3.42 

12 

4 

109 

iy4 

1.1 

24.9 

29 

3.5 

16 

5 

104 

1% 

.3 

23.6 

28.28 

3.55 

20 

2 

103 

iy4 

1.9 

83.6 

99.6 

1 

10 

1 

64 

% 

1 

83.8 

98.2 

1 

10 

1 

64 

% 

.5 

11.8 

13.2 

7.6 

3 

2 

45 

y 

0 

23.8 

23.8 

4.2 

0 

0 

150 

ly 

3.2 

16.6 

20.9 

4.7 

5 

16 

79 

1 

2.43 

34.8 

38.7 

3 

2 

6 

92 

1 

5 

91.8 

115.5 

.87 

32 

8 

160 

2 

11.5 

4.9 

24.2 

4.15 

8 

12 

5 

y4 

17.8 

9.4 

31.5 

3.12 

7 

28 

15 

y 

5.7 

5.7 

12.2 

8.2 

5 

35 

35 

% 

19.8 

7.9 

29.5 

3.3 

8 

101 

41 

ly 

.7 

10.2 

12.39 

8.07 

9 

4 

62 

% 

.9 

6.1 

7.7 

13 

4 

6 

40 

y 

.4 

6.8 

8. 

12.5 

5 

3 

42 

y 

THE    BATTLE    CREEK    SANITARIUM 


Calories  Per  Ounce 


s 

Calories 

Served 

■~t6 

■f,   P.O 

A  0/ 

^.s 

Oj 

w 

i  = 

"1/4  Gruel,  Cream  Gluten  4.3 

5  Gruels,  Creamed  Cracker 1.7 

4%  Gruel,  Farina  1.4 

6  Gruel,  Granola  2.7 

8  Gruel,  Granose  Flakes   8 

6  Gruel,  Oatmeal  1.3 

6  Gruel,  Plain  Gluten  9.3 

6  Gruels,  Potato,  Baked  7 

4%  Gruel,  Potato  Meal  1 

6  Gruel,   Rice   7 

5  Gruel,  Savorv  Potato  Meal....  2.9 

6  Gruel,  Taro  ". 3.7 

6  Gruel,  Taro  Cream  83 

8  Gruel,  Wheat  Flake  64 

3  Hash,  Potato  and  Celery  2.66 

31/4  Hash,   Potatoes   and   Onions..  2.35 

3  Hash,  Protose  8 

2%  Hash,   Vegetable   2.5 

2  Hoeoake  9.96 

41,4  Hominy    2.6 

414  Hominy,    Creamed    5 

2%  Hominy  Croquettes   5 

4%  Hominy  Grits  1.7 

1%  Honey    — .  .5 

414  Hulled   Corn   2.6 

5%  Hulled  Wheat  3.3 

31/2  Jellied   Peach   '. 58 

3  Jelly,    Cheri-y    

2%  Jelly,   Chocolate  3 

2  Jelly,    Cranberry   38 

3  Jelly,  Cueumbea' .5 

1  Jelly,  Currant  1.2 

3  Jelly,   Lemon    

2%  Jelly,   Orange   

3  Jelly,   Orange  and   Pineapple  .43 

3  Jelly,   Pineapple    

4  Jelly,  Tomato 3.2 

5  Kumyss    3.3 

1^  Lemon    Sauce   

^y<y,  Lemonade  - 

2%  Lemonade   Nog    12.4 

3  Lentil  and  Potato  Loaf  5 

3  Lentils  (Baked)   .- 8.23 

41/^  Lettuce  and  Celery  Stew  1.2 

114  Lettuce  with  Lemon  1.1 

2%  Macaroni  and   Cheese  — 6.2 

21^  Macaroni  and  Cornlet  4.02 

3  Macaroni  Croquettes  — 13.82 

4  Macaroni   and   Kidney  Beans  4.4 

3  Macaroni  and  Tomato  5.06 

3%  Macaroni  in  Tomato  Sauce....  1.4 

2%  Macaroni  au   Gratin   10.8 

3  Macaroni  Outlets  13.8 

3  Macaroni,  Egg 5.44 

1  Malt  Honey  Caramels  5.6 

114  Malt  Honey  Whip  1.1 

1  Malted  Milk  (Horlicks)   19.7 

114  Malted  Nuts  27.6 

5%  Malted  Nuts,  Cream  8.3 

6  Malted  Nuts,  Egg  Nog  10.8 


20.3 

12.9 

37.5 

2.7 

23 

108 

69 

2 

15.7 

4.6 

20.2 

4.9 

8 

69 

23 

1 

.04 

9.1 

10.5 

9.5 

6 

1 

43 

V'?. 

.9 

12 

15.6 

6.6 

18 

6 

76 

1 

.06 

4.9 

5.7 

17.5 

7 

1 

42 

% 

1.4 

5.8 

8.5 

11.7 

7 

8 

35 

% 

.5 

10.2 

20 

6 

17 

2 

81 

1 

5.7 

5.7 

12.2 

8.19 

5 

35 

35 

% 

.1 

10.2 

11.3 

8.9 

4 

1 

45 

1/0 

1.2 

5.8 

7.7 

12.9 

4 

8 

38 

1/? 

10.7 

11.9 

25.9 

3.8 

13 

53 

59 

iy4 

10.2 

1.5 

12.2 

8 

3 

62 

10 

% 

17.5 

2.2 

20.4 

4.8 

5 

106 

14 

iy4 

.22 

5.22 

6.1 

16.3 

5 

1 

44 

% 

9.66 

21 

33.3 

3 

8 

29 

63 

1 

10.79 

17.63 

30.7 

3.25 

7 

36 

57 

1 

4.3 

21.1 

33.4 

3 

24 

13 

63 

1 

7.1 

17.4 

27 

3.7 

6 

20 

49 

% 

45.8 

59.5 

115.3 

.9 

19 

90 

116 

21/4 

.5 

20.7 

23.8 

4.2 

11 

2 

87 

1 

14.4 

35.7 

54.6 

2 

20 

60 

145 

21/4 

8.3 

25.7 

39 

2.5 

13 

22 

65 

1 

.4 

14.5 

16.6 

6 

7 

2 

66 

% 

0 

94.7 

95.2 

1 

1 

0 

149 

11/0 

.5 

20.7 

23.8 

4.2 

11 

2 

87 

1 

1 

22 

26.3 

3.8 

18 

6 

126 

IVo 

3.48 

24 

28.1 

3.55 

2 

13 

85 

1 

16 

16 

6 

50 

Vo 

14.9 

17.4 

35.3 

2.84 

9 

42 

49 

1 

1.01 

49.7 

51.1 

1.9 

1 

2 

97 

1 

.3 

3 

3.8 

26.3 

1 

9 

tV 

90.1 

91.3 

1.09 

1 

99 

1 

30.57 

30.57 

3.2 

100 

1 

36.4 

36.4 

2.74 

100 

1 

.23 

24.5 

25.1 

4 

2 

73 

% 

41.06 

41.06 

2.4 

125 

11/4 

1.7 

9.21 

14.2 

7 

11 

7 

32 

v. 

5.6 

6.3 

15.2 

6.6 

16.5 

28 

31.5 

'   % 

37.3 

37.3 

2.7 

50 

y 

14.2 

14.2 

7 

75 

% 

.48 

25.6 

38.4 

2.5 

32 

2 

66 

1 

6.2 

27 

38.3 

2.7 

18 

22 

85 

11/4 

3.13 

19.38 

30.76 

3.3 

26 

12 

12 

1 

4.5 

6.87 

12.12 

9.6 

5 

16 

29 

% 

.6 

5 

6.7 

15 

2 

1 

V 

T^TT 

25.2 

12.8 

44.3 

2.5 

13 

59 

28 

1 

6.9 

11.86 

22.7 

4.4 

9 

15 

26 

1/0 

28.4 

32.35 

74.6 

.3 

41 

86 

98 

21/4 

6.36 

12.6 

23.4 

4.6 

19 

29 

52 

1 

3.86 

17.16 

26.08 

3.8 

15 

11 

49 

% 

8.7 

6.6 

16.9 

6.09 

3 

27 

20 

1/. 

15.82 

15.88 

44.8 

2.45 

30 

45 

50 

11/4 

28.4 

32.35 

74.6 

1.3 

41 

86 

98 

21/4 

20.7 

9.34 

35.5 

2.81 

15 

59 

26 

1 

0 

94.8 

100.4 

1 

6 

0 

94 

1 

0 

80 

81.1 

1.2 

1 

0 

99 

1 

23.4 

79.2 

121.7 

8 

20 

24 

81 

114 

73.6 

51.2 

152.4 

.65 

36 

96 

68 

2 

28 

15.4 

51.7 

1.9 

48 

163 

89 

3 

25.2 

13.65 

49.6 

2 

65 

153 

82 

3 

217 


THE    BATTLE    CREEK    SANITARIUM 


3  o  m 
O 


4  Malted  Nuts,  Frozen  9.2 

11^  Malted  Nuts,  Hot  27.6 

2       Maltol  --     0 

1  Maple  Sugar  0 

IVi  Maple    Syrup    

21/2  Marmalade,  Fig  -     2.8 

2%  Marmalade,  Prune  8 

1^2  Mayonnaise,   Cooked   ---     6.87 

21^  Meltose  or  Malt  Honey 

%  Meltose  Sauce  — -     1.1 

11/2  Meltose  with  Butter  33 

1%  Meltose,  whipiped  1.1 

61/2  Milk,  Skimmed  4 

6       Milk,  Whole 3.8 

2  Muffins,  Bran  --     8.8 

414  Baked  Mush   5 

5  Neetarines    4 

2       New  England  Stew 6.6 

2%  Normandy    Loaf 15.5 

2^2  Nut  and  Vegetable  Stew  6.3 

Vs  Nut  Butter  34.2 

21/4  Nut   Normandy   Chops   4.42 

23/2  Nut  Chops  - --     9.4 

2       Nut  Croquettes  18.6 

21/0  Nut    Cutlets    - 22.9 

2%  Nut    Fillet    - 15.11 

2       Nut  Fillet    (new)    22.89 

2%  Nut   Fillets  15.1 

1  Nut  Gravy  7.8 

21/2  Nut  Irish  Stew  8.9 

■2%  Nut  Loaf  with  Peas  18.2 

3%  Nut  Meat   Fillet   - 12.9 

41/,  Nut  Meat  Loaf  11.7 

3%  Nut   Meat   Pie   15 

2  Nut  Patties 18.6 

1%  Nut    Patties    - 2.6 

2%  Nut  Patties— Tomato   Sauee..  15.1 

3  Nut  and  Eice  Patties  13.25 

3       Nut  Ragout  - 8.97 

2       Nut    Sausage 18.62 

2%  Nut  Steak  with  Gravy  18.9 

%  Nuts,  Almonds  24.5 

1/4  Nuts,  Almonds  Salted  24.5 

1/2  Nuts,   Beech 25.5 

1/2  Nuts,    Butter    .- --;.  32.5 

1/2  Nuts,  Brazil  19.8 

1/2  Nuts,  Filberts  18.2 

%  Nuts,    Hickory    18 

1/2  Nuts,   Pecans    11.2 

1/2  Nuts,    Pine    39.5 

1/2  Nuts,   Pine,   Salted   39.5 

1/2  Nuts,  Walnut,   Eng 19.4 

2  Nuttolene    14.4 

3  Nuttolene-Apple  Sauce  9.7 

3       Nuttolene-Aptricot   Sauce   10 

2%  Nuttolene    and    Bechamel 

Sauce    -.  12.3 

2-      Nuttolene,    Baked    13.45 

2       Nuttolene  Broiled   14.4 

2       Nuttolene-Ohili  Sauce 14.4 


alories  ] 

Per  Ounce 

.|^ 

Calories 

Served 

■^ 

Pn 

I'd 

0 

■5t;o 

-So 
0°° 

^0 
0 

Is 

n  CO 

^'^ 
0 

a- 
•2  > 

0  to 

CM 

24.5 

17 

50.7 

2 

36 

96 

68 

2 

73.6 

51.2 

152.4 

.65 

36 

96 

68 

2 

88 

58.3 

146.3 

.7 

0 

220 

80 

3 

0 

96.6 

93.6 

1.1 

0 

0 

100 

1 

83 

83 

1.2 

100 

1 

.4 

48.7 

51.9 

1.9 

6 

1 

118 

1% 

.3 

43.9 

45 

2.2 

2 

1 

97 

1 

67.1 

2.85 

76.8 

1.3 

9 

88 

3 

1 

86.2 

86.2 

1.16 

200 

2 

.04 

80.6 

81.2 

1.23 

1 

49 

V2 

62.9 

62.2 

125.5 

.7 

100 

100 

2 

.04 

80 

81.14 

1.2 

1 

99 

1 

.8 

6 

10.8 

9.3 

26 

5.2 

39 

% 

11 

5.8 

20.6 

4.85 

23 

67 

35 

11/4 

34.8 

28.1 

71.8 

1.3 

18 

73 

59 

1% 

5 

26.1 

35.1 

2.77 

27 

21 

108 

1% 

0 

14.6 

15 

6.6 

2 

0 

73 

% 

6.3 

10.4 

23.3 

4.3 

14 

14 

22 

1/2 

44.3 

18.1 

77.9 

1.3 

39 

114 

47 

2 

6.36 

8.7 

21.3 

4.6 

15 

15 

20 

V2 

124 

20 

178.2 

.6 

28 

105 

17 

11/2 

19.6 

34.9 

58.9 

1.4 

12 

65 

73 

11/2 

26.4 

37.4 

73.2 

1.4 

22 

64 

89 

1% 

21.8 

9.15 

49.6 

1.55 

38 

44 

18 

1 

23.3 

15.26 

61.5 

1.6 

56 

57 

37 

11/2 

14.88 

16.6 

46.6 

2.14 

41 

40 

44 

m 

34.47 

16.8 

74.1 

1.3 

38 

58 

29 

11/4 

14.9 

16.6 

46.6 

2.14 

41 

40 

44 

11/4 

11.5 

4.9 

24.2 

4.15 

8 

12 

5 

1/4 

8.99 

12.31 

30.25 

3.3 

22 

22 

31 

% 

13,91 

11.31 

46.4 

2.15 

48 

46 

31 

11/4 

18.18 

16.51 

47.6 

2.1 

48 

66 

61 

1% 

17.2 

12.4 

41.3 

2.3 

44 

106 

50 

2 

18.4 

30.7 

64.2 

1.6 

47 

58 

95 

2 

21.85 

9.15 

49.6 

1.55 

38 

44 

18 

1 

.5 

20.7 

23.8 

4.2 

7 

2 

41 

V2 

20.8 

8.4 

44.4 

2.2 

34 

47 

19 

1 

9.64 

17.7 

40.6 

2.46 

40 

29 

56 

11/4 

27.14 

6 

41.5 

2.4 

26 

•  81 

18 

11/4 

51.01 

11.52 

81.6 

1.2 

30 

100 

20 

ly- 

25 

9.7 

53.6 

1.8 

53 

71 

26 

11/-, 

146.4 

20.2 

191.1 

.52 

7 

38 

5 

% 

.146.4 

20.2 

191.1 

.52 

7 

38 

5 

Vi 

153.1 

15.4 

194 

.5 

12.7 

76.5 

7.7 

1 

163.2 

4.1 

199.8 

.5 

16.2 

81.6 

2 

1 

178.1 

8.2 

206.1 

.48 

9 

87 

4 

1 

174.1 

15.2 

207.5 

.48 

9 

84 

7 

1 

179.7 

13.3 

211 

47 

9 

89.8 

6.6 

1  1 

188 

17.8 

217.8 

.46 

5 

87 

8 

1 

131.7 

8 

179.2 

.55 

23 

72 

5 

1 

131.7 

8 

179.2 

.55 

23 

72 

5 

] 

169.2 

18.2 

206.8 

.47 

9 

82 

9 

1 

27.7 

8.1 

50.2 

2 

29 

55 

16 

1 

18.9 

13.3 

42 

2.38 

29 

56 

40 

1V4 

18.4 

22.2 

50.6 

2.45 

31 

57 

37 

11/4 

30.5 

11.6 

54.4 

1.8 

34 

84 

32 

IV > 

31.2 

12.14 

56.87 

1 

25 

53 

22 

1 

27.7 

8.1 

50.2 

2 

29 

55 

16 

1 

27.7 

8.1 

50.2 

2 

29 

55 

16 

1 

218 


THE    BATTLE    CREEK    SANITAHIIM 


3  Niittoleme-Cranberry   Sauce   ..     9.7 

2%  Nuttolene  a  la  Cream 10.3 

2       Nuttolene  Croquettes  12.6 

2V2  Nuttolene  Cutlets  16.2 

2%  Nuttolene  Fricassee  10.35 

21/)  Nuttolene  and   Hollandaise 

Sauce    12 

21/2  Nuttolene    and    Jelly    12 

2  "  Nu)ttolene-Min/t  Sauce  14.4 

2^2  Nuttolene  and  Piquant  Sauce  13.2 
2i/>  Nuttolene  and  Tomato  Sauce  15.1 

4ii  Oatmeal    (Cooked)    3.3 

1%  Oatmeal   Stones   9.9 

1       Oatmeal  Wafers  13.3 

41^  Oats,  EoUed   (Cooked)    3.3 

5       Okra   and   Tomatoes   1 

i  Olive  Oil  0 

1  i  Olives,  Eipe    (7)    2 

4  Omelet   14 

3  Onion   Duchesse   4.49 

3       Onions,   Baked   3.16 

21/0  Onions,   Boiled   73 

3       Onions,   Creamed    1.73 

3       Onions,  Escalloped  - 2.7 

41/4   Onions  on  Toast  4 

5  Orange   Juice   0 

1       Orange  Marmalade   8 

1       Orange    Sauce    2.6 

714  Orange   Yogurt    2.7 

5       Oranges    - 9 

5       Oranges,    Blood    9 

3       Parsnips,   Browned    - 2 

3       Parsnips,    Creamed    —     2.56 

214,  Paisnips,    Escalloped    6.1 

3  Parsnips,   Mashed    1.7 

3%  Patties,  Peas 13 

21/2  Patties,    Eice    - 21.23 

5  Peach   Juice 0 

4  Peaches,    Fresh    9 

31/2  Peaches,    Cooked    -.- - 9 

%  Peanuts    30.1 

6  Pear   Juiee   0 

4       Pears    - 7 

4       Pears,  Cooked  7 

3       Peas,   Creamed   — —     6.36 

3       Peas,  English  Style 7.8 

3       Peas  in  Cream  6.16 

31/2  Peas  Creamed  on  Toast  6.49 

3       Peas,    Green 7.8 

31/0  Peas,  and  New  Potatoes  4.68 

3%  Peas,   Pattie  13 

3       Peas,    Puree    8.5 

3  Peas  and  Eice  Croquettes  -.--     5.6 
%  Pecans    -- 11.2 

414   Persimmons     95 

4%  Pie,  Apple  7.18 

4  Pie,  Blackberry   8.18 

4       Pie,  Bluelberry  5.2 

3%  Pie,  Cocoanut  Cream  6.46 

4       Pie,   Custard   4.9 


alories  Per  Ounce 

=   . 

Calories 

Served 

a 
ft 

Q 

1 

-  3^ 
0°° 

'0 

Si 

II 

0 

2^5 

•S  > 

P4 

18.8 

17.2 

45.7 

2.17 

28 

51 

46 

1% 

27 

8.4 

45.7 

2.2 

28 

74 

23 

IV4 

36.4 

16 

64 

1.8 

25 

70 

30 

11/4- 

32.66 

13.8 

62.5 

1.6 

40 

80 

30 

11/2 

23.18 

6.9 

40.43 

2.5 

25 

56 

19 

1 

41.2 

6.8 

60 

1.6 

30 

103 

17 

iv. 

22 

26 

60 

1.6 

30 

55 

65 

iv^ 

27.7 

8.1 

50.2 

2 

29 

55 

16 

1 

36.4 

11.4 

60 

1.6 

33 

91 

26 

IV. 

20.8 

8.4 

44.4 

2.2 

34 

47 

69 

11/. 

1.3 

13.4 

18 

5.6 

14 

5 

56 

•y+ 

19.4 

41.2 

70.6 

1 

18 

34 

73 

iy4- 

29.6 

80.5 

123.8 

.8 

14 

30 

81 

1% 

1.3 

13.4 

18 

5.6 

It 

5 

06 

■■•■A 

2.4 

4.3 

7.7 

14.2 

3 

8 

14 

1/4 

264.1 

0 

264.1 

.4 

0 

100 

0 

1 

69.1 

5 

76.1 

1.3 

2 

91 

7 

1 

59 

1 

74 

1.4 

56 

236 

4 

3 

33.8 

4.9 

43.26 

3 

12 

100 

13 

1% 

11.6 

18.98 

33.7 

2.93 

9 

34 

57 

1 

4.1 

3.3 

8.1 

12.1 

3 

12 

10 

1/4 

14.6 

5.6 

21.9 

4.5 

6 

50 

19 

% 

8 

9.6 

20.3 

5 

10 

30 

35 

% 

6.4 

21.2 

31.6 

2.8 

15 

25 

85 

iy+ 

0 

15.1 

15.1 

6.6 

0 

0 

75 

% 

2 

99 

109 

1 

8 

2 

99 

1 

32.25 

68.7 

103.5 

.96 

2 

32 

66 

1 

55 

12.3 

15.6 

5.8 

22 

5 

98 

iy+ 

.5 

13.5 

14.9 

6.7 

4 

2 

69 

% 

.5 

13.5 

14.9 

6.7 

4 

2 

69 

% 

11.85 

11.31 

25.2 

3.9 

6 

36 

33 

% 

6.5 

17.29 

26.35 

3.8 

7 

16 

52 

% 

10 

19.1 

35.2 

2.7 

13 

22 

40 

% 

5.9 

9.5 

17.1 

5.8 

5 

17 

28 

V2 

18.4 

23.4 

54.8 

1.8 

48 

66 

86 

2 

54.02 

40.5 

115 

.83 

20 

43 

37 

1 

0 

20.8 

20.8 

4.8 

0 

0 

100 

1 

.3 

11.6 

12.8 

7.8 

3 

1 

46 

¥2 

.3 

19.7 

20.9 

4.8 

3 

1 

71 

%- 

102.9 

8.5 

161.5 

.6 

22.5 

77.1 

6.3 

1 

0 

25.6 

25.6 

3.9 

0 

0 

150 

11/2 

1.3 

16.5 

18.5 

5.4 

3 

5 

67 

% 

1.1 

23.3 

25.1 

4 

3 

4 

93 

1 

9.9 

13.74 

30 

3 

16 

24 

35 

% 

9.1 

17.5 

34.4 

3 

23 

26 

51 

1 

22.5 

13.83 

42.5 

2.3 

18 

63 

41 

iVi 

13 

26.24 

45.75 

2.18 

20 

44 

86 

11/2 

9.1 

17.5 

34.4 

3 

23 

26 

51 

1 

9.86 

21.13 

35.68 

2.8 

16 

35 

74 

1% 

18.4 

23.4 

54.8 

1.8 

48 

66 

86 

2 

9 

17.5 

35 

0 

24 

2o 

50 

1 

3.3 

28 

36.9 

2.9 

12 

26 

62 

1 

188 

17.8 

217.8 

.46 

;    5 

87 

8 

1 

1.86 

36.7 

39.5 

2.5 

4 

9 

162 

1% 

16.7 

35.18 

59.1 

1.6 

32 

78 

165 

2% 

14.36 

43.1 

66.64 

1.5 

43 

77 

230 

31/2 

12.7 

47.4 

65.3 

1.5 

20 

49 

181 

2-i/o 

23 

31.31 

16.85 

1.65 

:  21 

76 

103 

2 

16.8 

30.5 

52.2 

1.9 

20 

64 

116 

2 

219 


THE    BATTLE    CREEK    SANITARIUM 


c?  fc 


[lories   Per   Ounce 

S5 

Calories 

Served 

L 

o 

a 
o 

C3 

1^ 

14.6 

46 

68.6 

1.46 

33 

58 

184 

2% 

21.4 

21.9 

73.7 

1.3 

42 

87 

171 

3 

24.1 

26 

57.1 

1.76 

36 

126 

138 

3 

26.9 

38.7 

73.54 

1.3 

35 

120 

170 

31/4 

22.2 

35.1 

72.4 

1.3 

73 

108 

169 

31/2 

23.7 

29.8 

59.9 

1.6 

22 

90 

113 

2  ¥4 

19.31 

35.67 

66.3 

1.5 

43 

73 

134 

2% 

7.26 

24.88 

35.4 

2.8 

36 

71 

168 

2% 

14.36 

43.1 

65.64 

1.5 

43 

77 

230 

3% 

22.7 

36.5 

63.5 

1.58 

21 

126 

203 

31/^ 

60.5 

26.3 

109.5 

.91 

45 

128 

52 

2y4 

131.7 

8 

179.2 

.55 

23 

72 

5 

1 

.8 

11.3 

12.6 

8 

2 

3 

45 

% 

0 

21.8 

21.8 

4.5 

0 

0 

100 

1 

.85 

29 

21.4 

4.6 

2 

3 

70 

% 

23.5 

23.7 

4 

5 

95 

1 

31.3 

37.4 

2.67 

3 

97 

1 

13.3 

91.8 

117.6 

.85 

5 

5 

40 

% 

17.61 

31.48 

55.4 

1.8 

14 

40 

71 

iy4 

18.3 

20.4 

44.7 

2 

17 

51 

57 

11/4 

11.25 

59.7 

75 

1.34 

12 

33 

180 

2% 

18 

17.5 

40 

2.5 

18 

112 

70 

2 

25.8 

21 

52.2 

1.9 

17 

73 

60 

1% 

17 

10.4 

30.1 

3.3 

13 

86 

51 

1% 

15 

17.34 

36.5 

2.7 

14 

52 

59 

1% 

17.61 

31.4 

55.4 

1.8 

14 

40 

71 

1% 

25.77 

15.06 

45.3 

2.1 

10 

57 

33 

1 

.4 

28.9 

32.7 

3.06 

11 

1 

88 

1 

.3 

24.4 

27.6 

3.5 

7 

1 

67 

% 

5.17 

29.12 

77 

2.6 

11 

17 

97 

1V4 

8.1 

23.4 

35.2 

3 

10 

22 

68 

1 

12.87 

18.74 

34.81 

2.8 

11 

46 

68 

m 

10.7 

21 

35.3 

2.75 

15 

45 

90 

1V2 

5.17 

29.4 

38.07 

2.6 

11 

17 

97 

11/4 

13.4 

22 

38.2 

2.6 

8 

35 

57 

1 

19.27 

21.9 

44.15 

2.2 

9 

54 

62 

1% 

12.9 

14.8 

39.4 

2.6 

50 

58 

67 

1% 

13.4 

22 

38.2 

2.6 

8 

35 

57 

1 

.3 

24.4 

27.6 

3.5 

7 

1 

67 

% 

28.7 

17.9 

49 

1.3 

9 

86 

55 

IVo, 

9.66 

21 

33.3 

3 

8 

29 

63 

1 

22.4 

27 

54.9 

1.8 

20 

82 

98 

2 

16.76 

41.6 

61.65 

1.6 

9 

47 

119 

1% 

10.79 

17.63 

30.7 

3.25 

7 

36 

57 

1 

1.8 

22.6 

27.5 

3.6 

7 

5 

63 

% 

8 

20.8 

31.8 

3.14 

9 

25 

66 

1 

5.6 

49.1 

58.2 

1.71 

12 

19 

169 

2 

10.96 

21.55 

35.51 

2.8 

8 

30 

62 

1 

12.87 

18.74 

34.81 

2.8 

11 

46 

68 

1% 

7.75 

21.84 

34.1 

2.93 

16 

29 

80 

m. 

13.16 

15.72 

31.1 

3.1 

7 

42 

51 

1 

4.9 

20 

27.1 

3.7 

8 

18 

74 

1 

17.92 

15.48 

37.34 

2.6 

13 

60 

52 

iy4 

.3 

24.4 

27.6 

3.5 

7 

1 

67 

% 

38 

54 

100 

1 

4 

19 

27 

% 

21.1 

30.2 

55.5 

1.8 

14 

66 

95 

1% 

11.25 

59.7 

75 

1.34 

12 

33 

180 

2y4 

42.2 

9.2 

75.3 

1.3 

45 

65 

15 

1% 

16 

10.2 

49 

2 

47 

33 

20 

1 

4  Pie,  Cheriy  8 

4  Pie,  Date  Cream  10.31 

51/4  Pie,  Date  Pumpkin 7 

4  Pie,  Lemon  7.94 

5  Pie,  Mince  15.09 

4  Pie,  New  England  Cream 6.42 

3%  Pie,  Orange   (1-6  Pie)    11.39 

5  Pie,    Pumpkin 3.25 

5  Pie,    Raspberiy    8.18 

5%  Pie,    Squash    4.27 

2  Pine  Nut  Roast 22.7 

Va  Pine  Nuts 39.5 

4  Pineapple,  Fresh  5 

5  Pineapple  Juiee  0 

31/4  Pineapple    Sauce    57 

4  Plums 1.2 

2%  Plum  Sauce  1.1 

V2  Popped    Corn    12.5 

2%  Potato   Cakes   6.3 

3  Potato  au  Gratin 5.97 

3  Potato,  Baked   Sweet  4.11 

4  Potato  Balls  .-     4.5 

3  Potato  Cakes  and  Protose  — .     5.6 

4%  Potato  Chowder 2.7 

3%  Potato    Loaf    4 

21/4  Potato  Croquettes  6.3 

21/0  Potato   Salad   4.56 

3  Potatoes,  Baked  3.4 

3  Potatoes,  Boiled 2.9 

314  Potatoes,  Browned  3.48 

3  Potatoes,  Cream  Baked 3.7 

31/4  Potatoes  in  Cream  Sauee  3.2 

414  Potatoes,  Esealloped  3.6 

31/4  Potatoes,  Glazed  —     3.5 

2%  Potatoes,    Hashed    2.8 

2%  Potatoes,   Hashed   Cream  2.9 

414  Potatoes,  Hashed,  and  Poaehed 

Eggs 11.7 

2%  Potatoes,   Hashed  Bro-wned....     2.8 

3  Potatoes  in  Jackets 2.9 

3  Potatoes,   Lyounaise 2.4 

3  Potato  and  Celery  Plash  2.66 

31/2  Potatoes  (creamed).  Sweet  .—     5.5 

2%  Potato   Crociuettes,   Sweet   --     3.36 

31/4  Potato   and   Onion   Hash 2.35 

3  Potato  and  Rice  Croquettes  ..     3.1 

314  Potatoes,  Mashed  3 

31/4  Potatoes,  Mashed  Sweet  3.5 

3  Potatoes,  Minced  3.02 

31/0  Potatoes,  New  Creamed 3.2 

3%  Potatoes,  New,  with  Peas  ....     4.46 

3  Potatoes,    Parisian    2.3 

3%  Potatoes,   Savory  2.2 

31/4  Potatoes,  Sliced  in  Cream  ....     3.94 

3  Potatoes,  Steamed  2.9 

1  Potato   Rosettes   8 

31/0  Potatoes,    Stuffed    4.2 

3  Potatoes,  Sw^eet,  Browned  — -     4.11 

1%  Pressed  Meat   23.9 

2  Protose 22.8 


220 


TliE    BATTIiE    CREEK    SANITARIUM 


Sg.S 


Dries   P 

'er   Ounce 

C 

alories 

Servet 

1 

s 

fe 

■22 

'o 

^ 

CIS 

12.17 

6.22 

31.4 

3.1 

53 

48 

24 

m 

30.1 

7.6 

57.7 

1.8 

61 

91 

23 

1% 

16 

10.2 

49 

2 

47 

33 

20 

1 

20 

8 

45.5 

2.1 

48 

55 

22 

11/4 

20.1 

26.56 

57.28 

1.7 

32 

61 

82 

1% 

31.36 

7.93 

52.9 

1.9 

32 

75 

18 

11/4 

19.4 

17.3 

61.2 

1.64 

50 

40 

35 

11/4 

16 

10.2 

49 

2 

I 

135 

33 

1% 

12.8 

9.93 

34.73 

2.8 

43 

46 

36 

11/4 

4.3 

21.1 

33.4 

3 

24 

13 

63 

1 

22.2 

9.2 

52.9 

1.89 

50 

52 

23 

11/4 

22.77 

7.52 

42.1 

2.37 

35 

68 

22 

11/4 

22.7 

12.6 

56.5 

1.76 

47 

50 

28 

iy4 

21.85 

9.15 

49.6 

1 

38 

44 

18 

1 

16 

10.2 

49 

2.8 

47 

33 

20 

1 

10.56 

22.77 

48.46 

2.05 

39 

27 

59 

11/4 

41.9 

28.4 

117.9 

.78 

31 

29 

40 

1 

17.5 

17 

47.3 

2.1 

59 

84 

82 

2V4 

2.5 

9.7 

53.6 

1.8 

53 

71 

26 

1% 

20 

11.76 

51 

2 

47 

49 

29 

11/4 

10.5 

24 

37.9 

2.8 

14 

35 

76 

114 

.3 

43.9 

45 

2.2 

2 

1 

97 

1 

.3 

26.4 

27.5 

3.65 

3 

1 

96 

1 

21.8 

20 

46.6 

2.1 

13 

58 

54 

11/4 

32 

19.12 

57.56 

1.75 

22 

112 

66 

2 

23.5 

30.38 

58.83 

1.7 

16 

80 

104 

2 

22.1 

19.63 

45.98 

2.1 

14 

72 

64 

11/0 

23.3 

66.75 

97.2 

1 

20 

60 

170 

21/2 

15.3 

34.7 

54.7 

1.83 

12 

42 

96 

IVo 

.73 

27.17 

28.4 

3.52 

2 

2 

96 

1 

9.22 

16.37 

30.38 

3.33 

11 

23 

41 

% 

17.58 

26.44 

48.5 

2.07 

12 

45 

68 

11/4 

28.5 

48.2 

86.7 

1.9 

34 

99 

167 

3 

32.49 

59.84 

92.85 

1.08 

22 

80 

123 

21/4 

26.8 

49.2 

88.5 

1.1 

42 

90 

168 

3 

23.2 

49.7 

79.6 

1.2 

22 

80 

173 

2% 

22.67 

48.9 

79.93 

1.26 

28 

77 

170 

2% 

27 

50.39 

87.39 

1.15 

35 

93 

172 

3 

37.2 

46.8 

94.1 

1.06 

35 

129 

161 

31/4 

26.5 

50.3 

86.2 

1.16 

29 

84 

162 

234 

26.1 

48.4 

84.5 

1.18 

33 

86 

156 

2% 

.51 

19.9 

20.09 

5 

2 

2 

71 

% 

.3 

6.7 

8.5 

11.7 

1 

5 

tV 

8.8 

88.8 

100.6 

1 

3 

9 

88 

1 

5.8 

57.6 

65.4 

1.53 

6 

18 

176 

2 

2.6 

14.7 

19.3 

5.2 

8 

10 

57 

% 

14.7 

15.9 

6.3 

4 

46 

1/2 

0 

29.4 

29.4 

3.4 

0 

0 

150 

1% 

0 

23.7 

23.7 

4.2 

0 

0 

125 

11/4 

2.2 

27.5 

31.3 

3.25 

5 

7 

88 

1 

22 

23.2 

4.3 

4 

71 

% 

.9 

96.6 

106 

.94 

7 

1 

92 

1 

20.7 

24.07 

49.28 

2.02 

13 

63 

74 

IVo 

.3 

28.5 

32.1 

3.1 

13 

1 

111 

11/4 

.34 

39.72 

43.94 

2.27 

16 

2 

182 

2 

18.9 

23.1 

48.3 

2 

20 

59 

71 

11/. 

11.61 

21.8 

36.39 

2.7 

16 

64 

120 

2 

6.04 

35.6 

45.7 

2.2 

9 

13 

78 

1 

8.7 

48.2 

67.2 

1.5 

19 

16 

90 

11/4 

4       Protose,    Braized    13 

3       Protose,  Breslau  of  19.9 

2  Protose,    Broiled    22.8 

2%  Protose    Broiled    with    Miish- 

room    Sauce    17.5 

3  Protose  Creamed  on  Toast  ....  10.6 
2^2  Proitose,  Ohipped  in  Cream  ....  13.61 

2  Protose  Outlets 24.5 

1%  Protose   Croquettes   22.8 

4  Protos3    Fillet    12.06 

3  Protose   Hash   8 

21/4  Protose  and  Mayonnaisie  21.6 

3       Protose,  Minoed  on  Toast  .-  11.88 

2%  Protose,    Panned    21.2 

2       Protose   Patties   18.6 

2  Protose,   Potted   22.8 

2l^  Protose   and   Eice   Croquettes  15.13 

21/0  Protose    Roast    47.7 

414  Protose  Eoast  with  Dressing..  12.8 
21/0  Protose  Steak  with  Gravy  ....  18.9 
21/2  Protose  Steak  with  Onion 19.24 

3  Prune  Fritters  3.4 

21/4  Prune    Marmalade    8 

3%  Prunes   (Cooked)   8 

2%   Pudding,  Baked  Indian   4.8 

31/2  Pudding,  Bread 6.44 

31/2  Pudding,  Choeolate  4.95 

314  Pudding,  Cream  Rice  4.25 

2%  Pudding,  Bate   7.2 

2%  Pudding,  Fig  4.7 

31/2  Pudding,  Sago  53 

21/2  Pudding,  Snow  4.78 

214  Pudding,  Apple  Tapioca  4.5 

31/2  Pufifs,    Choeolate    9.9 

2  Puffs,   Cocoanut  9.52 

31/4   Puffs,  Corn 12.5 

3%   Puffs,   Currant   6.6 

2%  Puffs,  Fig  8.5 

31/2  Puffs,  Graham 10 

31/2  Puffs,  Nut  10.1 

3%  Puffs,  White  9.4 

3%  Puffs,  Whole  Wheat  10 

3%  Quince  Sauce  48 

1       Radishes    1.5 

1       Raisins    3 

3  Raisins,   Cooked   2 

4  Raspberries,  Fresh  Black  2 

31/4  Raspberries,  Fresh  Red  1.2 

5  Raspberry   Juice    (Black)    ....     0 

5       Raspberry  Juice    (Red)    0 

31/4  Raspberry  Sauce,  Black  1.6 

31/4  Raspberry  Sauce,  Red  1.2 

1  Rice   Biscuit   8.5 

3  Rice  a  la  Carolina  4.41 

4  Rice,   Boiled   3.3 

41/2  Rice,   Browned   3.88 

3       Rice  and  Cheese  6.3 

514  Rice  with  GVeole  Sauce  2.99 

21/4  Rice   Croquettes   4.08 

2  Rice   Cutlets   10.3 


221 


THE    BATTLE    CREEK    SANITARIUM 


Calories  Per  Ounce 


Calories   Served 


<B   CI- 


%  Rice    Flakes 

3  Rice  Patties  -nitli  Sauce  

2%  Rice  Patties   

21/4  Rice  and  Peas  

%  Rice,   Puffed   

5  Rice  with  Raisins 

41/4  Rice,  Steamed  or  Creamed 

5  Rice,  Steamed  and  Raisins  ...- 

2%  Rolls,   Cocoanut 

2  Rolls,    Cream    

2%  Royal    Scallop    -.. 

2  Rutabagas,   Baked   

4  Ruta-bagas,  Mashed  

11^  Salad,  Apple  and  Celery  

1%  Salad,  Apple,  Cheese  and  Nut 

21/4  Salad,  Banana  Cherry  Sauce.. 

11/4  Salad,  Banana  Mayonnaise.... 

iy2  Salad,  Banana  and  Walnut.... 

1%  Salad,    Bean,    String    and 

French  Dressing  

4  Salad,  Beet  and  Bean  

11/4  Salad,   Beet   and   Lemon    

21/4  Salad,  Beet  and  Potato  

4  f  Beets  in  Aspic  and  Mayon- 
naise   

3  Salad,  Beets  and  Mayonnaise 

21/2  Salad,  Berkley 

2  Salad,  Cabbage 

2  Salad,  Cabbage  and  Celery.... 

2  Salad,  Cabbage,  Chopped  

2^  Salad,    Cabbage-Lemon    

1%  Sa.lad,  Cabbage  and  Olive  

2  Salad,  Carrot  

3  Salad,  Carrot,  raw  

1%  Salad,  Carrot  and  Nut  

2  Salad,    Cauliflower    

2  Salad,  Celery  No.  2 

1  Salad,  Celery  

2  Salad,   Celery  No.    1   with 
Mayonnaise 


1%   Salad,  Celery  Relish  

%  Salad,  Cheese  Balls  

11/4   Salad,  Chili  Sauce  

2%   Salad,  Cold  Slaw 

2%   Salad,  Combination  Green  ..  .. 

3       Salad,  Cucumber  Jelly 

6%  Salad,  Cucnmber  and  Tomato 

2^   Salad,  Date  and  Apple  

1%   Salad,  Date  and  Walnut  

%  Salad  Dressing,  French 

%  Salad   Dressing,   Golden   

214  Salad,  Egg  Mayonnaise 

1%  Salad,  Endive  and  French 
Dressing -. 

3  Salad,  Filberts  and  Celery  .... 
•2       Salad,    French 

21/4   Salad,   Fruit   

3%  Salad,  Fruit  a  la  Cream  ......... 

4  Salad,  Fruit  Macedoine  N0.I-. 
3       Salad,  Fruit  Macedoine  No.  2.. 


8.0 
7.75 

21.23 
0.01 
9 

2.99 
3.28 
2.99 
9.3 

11.4 

20.6 
5.3 
.6 
2.26 
9.41 
1.5 
3.4 
5.34 

.7 
3.01 

.97 
4.27 

3.1 
3 

.57 
2.6 
L93 
1.9 

.63 
2.3 
2.4 
3.1 
4.7 
2.5 
1.5 
1.3 

2.5 

2.8 
21.3 

4.91 

3.24 
.9 
.5 
.8 

2.5 

5.9 

0 

4 
13.37 

1.1 
4.59 
4.5 
1.98 
1.3 
.9 
.9 


.9 
17.02 
54.4 
25.29 
.8 
.99 
9.91 
.99 
52 
22.5 
52.8  . 
29.9 
2.8 
4.27 
59.2 
1.9 
18.3 
40.3 


96.6 
14.4 
40.5 
28 
92 

25.98 
21.18 
25.9 
64.1 
83.5 
14.9 
64.7 
2.7 
26.16 
39.44 
32.5 
26.41 
20.7 


106 

33.9 
115 

59 
101.8 

29.96 

34.37 

28.9 
125.4 
117.4 

88.3 

100.9 

6.1 

32.69 
108.7 

35.9 

48 

66.5 


.94 
2 

.83 
1.69 

.98 
3.4 
2.9 
3.4 

.8 

.8 

1.2 

1 

16.4 

3.5 

.94 
2.78 
2.06 
1.5 


51.7  2.3  54.7  1.8 

17.7  5.2  25.91  3.9 

.10  3.6         4.7  5.3 

16.56  14.21  35  2.85 


10.5       3.2 
15  7 

.72  22.4 
15.66     8 
15.55 
18.2 
2.35 


72.6 
14.3 
30.2 
81.2 
19.7 
61.8 
.3 


7.46 
17.2 

2.8 

4.8 

9.2 
12.9 

9.4 

3 

3.1 

3.9 


13.9  3.3 

15  3.5 

105.3  6.6 

2.6  28.2 

9.15  11.7 


19.6 
.3 
10 

5.8 

34.8 

198.07 

8.5 
30.66 

15.8 

34.92 

3.8 


3.9 

3 

3.8 

45.8 
58.6 

2.85 
45 

1.46 

4 
15.91 
18.9 


2.53  26.8 


12 
.5 

1.5 


20 

12.6 

11.6 


16.8 

25 

23.7 

25.72 

24.9 

37.5 

5.78 
79.7 
26.1 
46.2 
95.2 
25.2 
16  9 

5.5 

19.6 
17.8 

134.2 
35.8 
24.1 
24.4 
5.8 
14.6 
54.1 
99.3 

201 
57.5 
44.5 

55.9 

55.43 

27.3 

31.3 

33.3 

14 

14 


5.9 
142 
4.6 
3.8 
4 

2.6 
17.1 
1.5 
3.7 
2.6 
1.1 
4 
1 
18.1 


3 

25 

20 

10 

4 

12 

14 

12 

28 

27 

53 

12 

2 

4 

10 

3 

3 

8 

2 
11 


14 
9 
1 
4 
3 
4 
1 
4 
4 
8 

10 
4 
3 
1 


5.1 
5.6 
6.6 
2.7 
4.1 

.5 
26.3 
6.8 
1.85 
1 

.5 
1.72     3 
2.25  30 


2 

1.8 

3.6 

3.1 

3 

8 

6 


91 
13 
8 
5 
5 
2 
2 


57 
43 
57 

5 
42 

5 

144 

53 

134 

59 

12 

6 
84 

3 
19 
60 

93 

69 

1 

36 

46 

45 

1 

30 

33 

37 

5 

113 

28 

84 

125 

40 

116 

0 

34 

1 

79 

3 

19 

39 

0 

68 

13 

44 

99 

8 

69 

7 
104 
7 
8 
45 
1 
3 


47 

43 

37 

58 

46 

133 

94 

133 

178 

195 

38 

129 

11 

40 

56 

69 

28 

32 


15 
21 
48 
16 
14 
34 

6 

8 
18 
33 
15 

6 

6 

5 

9 

20 

5 

40 
24 

9 

9 

26 

107 

74 

1 
39 

1 

1 
58 
35 

62 
75 

47 
45 


1/2 
11/4 
1 
11/4 

1/2 
11/2 
11/0 
]% 
31/2 
23/4 

21/4 

2 
1/4 
V2 

11/2 
% 
1/2 

1 


5      1 

20      1 
10        i/s 
30        % 


% 
% 
1/2 
1/2 
% 
% 
Vs 

11/4 
1/2 

11/4 

11/0 
1/2 

1% 


1/2 
1/4 
1 

1/2 
1/2 

1/2 

1 

TTT 
1 

1% 
11/4 
1 

1/2 
1 


1% 
1/2 
% 

1% 
1/2 
% 


222 


THE    BATTLE    CREEK    SANITARIUM 


Calories  Per  Ounce 


-3  in 
M  "  e 


1       Salad,  Grape  Catsup  2.66       7.6i  68  2  78  5 

L/    f^l'^'^'-P^'^P*'  '^2         .85  25.'l  26.'84 

ZYi  balad,  Lettuce  and  Egg 6.86     41  1  94     .50  8 

1%   Salad,   Lettuee   with   Lemon..     1.1           .6       5  6  7 
1%  Salad,    Lettuce    and    Mayon- 

^1/    o'l'^'f^;- .■■■• 2-7       22          3.8  28.5 

/yo   balad,  Macedioine  I.35     342     125  485 

3       Salad,  Mint  Jelly  0            0 "     38  '  38  * 

214   Salad,  Nuttolene  and  Apple..     4.9       10        29.5  44.4 

1  i  Salad,  Olive,  ripe  (7)   2          69.1       5  76.1 

2  Salad,  Orange  and  Celery  1.3         1.2     19.4  22^04 

2  Salad,  Orange  and  Cocoanut..     1.7       21.5     14.6  .37.9 

3  ^   Salad,    Peas    and    Celery 6.24     16.02  12.5  34.8 

2  t  Salad,  Persian  I.7         gg     34  7  453 

414   Salad,  Pineapple  and  Nut 7.46     73.4       9.62  90.54 

2       Salad,   Pineaj)'ple  and   Straw- 
berry       1.7         34     21  5  26  6 

21/2   Salad,  Potato  4.56     25.77  ]5.0;i  45  39 

2       Salad,   Protose   and   Celery....  23.66     67.73   12.56  103.9 

1       Salad,  Eadisli  I.5           .3       q  j  g'g 

2%   Salad,  Eoyal  11.6       38.4       6^2  56  2 

214  Salad.    Sliced  or  Chopped  Beet     2.7           .3       8.6  116 

1  Salad,  Split  Eail  14          67        19  100 

1%  Salad,    String   Bean   7       51.7       9.3  54  7 

2  Salad,  SumrneT  3.79       4.64     6.58  I5' 

214  Salad,  Tomato  85     36.8       4.1  41.9 

21/i   Salad,  Tomato  and  Cucumber'    2.17     14.3       4^25  20^7 

4       Salad  in  Tomato  Cups  1.86     11.1       5.9  18.9 

4       Salad,  Tomato  Jelly 3  29       1.77     9.21  142 

3%  Salad,    Tomato   Jelly  Mayon- 

,           naise    ;. 3.17       1.71     g.S  13  6 

4       Salad,  Sliced  Tomato  1            l.i       46  6  7 

2%   Salad,  Waldorf  5.29     36.1     35  96  3 

1  i  Salad,  Water-cress  1.1            6       5  76 'l 

2  Salad,  Water-lily  15          33'         15  59' 

21^  Salad,  Vegetable  4.3         4.8       9.2  18  3 

2       Salad,  Wintergreen  and  Apple       .20         .56  25.5  25  8 

1%   Salad,  Yogurt  Cheese  13.5     121.2       3.5  138  3 

Vi  Salad,     Yogurt     Cheese     and 

Celery 10.76     41.4       4.72  57  12 

Salad  Dressing: 

V2       Mayonnaise  with  Oil  3  4     192.2        1.7  197  6 

1%       Mayonnaise,   Cooked   6.87     67.1       2^85  76.8 

1  Mayo-nnaise,  Raw 2.1     196  1       1  19923 

}Yj    „  Yogurt  ._ 3.1       90.2       3.9  97.3 

1%   Sandwich,   Baked  Bean   4.27     19.4     23.9  47.57 

314   Sandwich,  Cheese  &  Pineapijle     8.5       61.3     38.4  89" 

314  Sandwich,    Cheese   &    Tomato     8.9       62.5     37.4  89 

1%  SandM-ich,   Cottage  Cheese 11.2       33.9     37.6  82.8 

2  Sandwich,  Cucumber  5.8       38.6     32  9  775 

1%  Sandwieh,    Egg    10          5o'.12  39".09  99'2 

I'fj  Sandwich,   Fig   6.08     30.47  53.66  90.22 

31/2   Sandwich,  Fruit  6.5       33.7     59  992 

11/2  Sandwieh,   Jelly   7.4       38.'6     70.6     llfj'e 

l-Yi  Sandwich,   Jelly  and   Lettuce     5.6       30.5     49  86  5 

1%  Sandwich,    Lettuce 6.8       38.2     37  82 

1%  Sandwich,    Nuttolene    8.7       42,1     40.4  91.4 

1^     Sandwich,  Peanut  Butter  22.5     106.8     70.'9     200.1 

1%  Sandwieh,     Protose     Mayon- 
naise         9          40.7     38.2  88 

223 


„_• 

Calories  Served 

a.2o 

inces 
lie  por 
f  100 

oteins 

. 

ll 

■i> 

X  ~  °    ,r 

a 

SM 

0  g 

0 

'(I4 

1.2   2 

7 

66 

% 

4     1 

1 

48 

Vo 

2.25  20 

100 

5 

IV4 

15     2 

1 

7 

iV 

3.5   5 

38 

7 

V. 

2    4 

89 

32 

1% 

3    0 

0 

100 

1 

2.25  10 

23 

67 

1 

1.3   2 

91 

7 

1 

4    4 

4 

42 

v.. 

2.6   3 

43 

29 

% 

2.8  18 

46 

36 

1 

2    5 

27 

93 

1V+ 

2.25  13 

141 

43 

2 

3.7   3 

6 

41 

V. 

2.1  10 

0/ 

33 

1 

.96  44 

132 

24 

0 

11.7   1 

0 

5 

^ 

1.78  25 

86 

14 

IV, 

8.65  5 

1 

19 

14 

1    14 

67 

19 

1 

1.8   2 

93 

5 

1 

5.6   6 

8 

11 

V, 

2.3   2 

86 

12 

1 

5    5 

34 

11 

v. 

5.2   7 

45 

23 

% 

7    11 

7 

32 

V2 

7.3  12 

37 

26 

% 

16    4 

4 

17 

% 

1    12 

131 

82 

234 

1.3   2 

91 

7 

1 

2   30 

67 

3 

1 

5.5   6 

6 

13 

V, 

3.9   0 

1 

49 

V. 

.5  20 

175 

5 

2 

1.7   2 

10 

1 

Vs 

.48  2 

97 

1 

1 

1.3   9 

88 

3 

] 

.5   2 

196 

2 

2 

1    5 

138 

7 

1% 

2    12 

62 

76 

Wo 

1.1  30 

210 

130 

3 

1.1  30 

210 

130 

3 

1.2  20 

61 

69 

1% 

1.3  11 

74 

65 

IV. 

1    15 

75 

60 

IVo 

1.1  10 

50 

90 

1V-. 

1    23 

118 

209 

31/. 

.8  10 

49 

91 

IVo 

1.1  10 

54 

86 

lu 

1.2  12 

71 

67 

IV. 

1.09  14 

70 

66 

IVo 

.5  22 

107 

71 

2 

1.1     15 


69 


66     \y.. 


THE    BATTLE    CREEK    SANITARIUM 


.2  >■- 

ffi  rt  fi 

CD  d<^ 

3  i<  0) 

i  O   to 


lories  Per   Ounce 

-  °o 

Calories 

Served 

ll 

1^ 

"3 

O 
en 

500 

0 

s 

fe 

ll 

•9  =3 

1^ 

PL4 

56.5 

44.7 

109 

.91 

20 

150 

130 

3 

56.8 

11.9 

77.4 

1.4 

8 

56 

11 

% 

28.2 

28.5 

61.9 

1.4 

12 

68 

70 

11/2 

44.3 

7.1 

74.1 

1.3 

50 

216 

84 

31/2 

35 

48.6 

93.8 

1 

28 

92 

130 

21/2 

40.9 

41.5 

89.7 

1.6 

24 

136 

140 

3 

22.4 

7.8 

33.2 

3 

7 

51 

17 

% 

13 

8.9 

25.9 

3.9 

8 

26 

16 

% 

32.6 

13.5 

53.1 

1.88 

18 

76 

31 

1% 

14.6 

5.8 

21.4 

4.7 

2 

34 

14 

% 

11.8 

4.9 

24.2 

4.15 

8 

12 

5 

1/4 

31.7 

10.3 

46.3 

2.6 

9 

69 

22 

1 

17.8 

9.4 

31.5 

3.12 

7 

28 

15 

% 

28.8 

5.9 

37.2 

2 

6 

57 

12 

% 

41.9 

5.9 

50 

2 

5 

84 

11 

1 

98.9 

.57 

102.1 

5 

1 

48 

1 

% 

0 

18.28 

18.28 

5.4 

0 

0 

25 

V4. 

37.6 

5.58 

45.4 

2.6 

1 

22 

2 

% 

22.9 

9 

35.6 

2.8 

7 

50 

18 

% 

10.50 

5.42 

22.12 

4.52 

14 

24 

12 

% 

11.5 

7.2 

21.2 

4.9 

8 

15 

52 

% 

17.15 

5.51 

23.7 

4.2 

2 

37 

11 

% 

30.71 

3.93 

36.15 

2.16 

2 

43 

5 

% 

30.7 

3.9 

36.1 

2.76 

3 

64 

8 

% 

83.3 

11.6 

109.2 

.92 

19 

115 

16 

IV9. 

37.3 

43.6 

81 

1.2 

0 

23 

27 

% 

20.4 

20.1 

44.3 

2.2 

4 

23 

23 

V9. 

49.2 

10.14 

64.2 

1.6 

1 

20 

4 

% 

25.5 

21.2 

50.6 

1.97 

4 

25 

21 

% 

53.1 

71 

1.26 

.8 

2 

42 

56 

1 

32.6 

67 

99.7 

.72 

0 

66 

134 

2 

0 

37.3 

37.3 

2.7 

0 

0 

50 

% 

4 

80.6 

81.2 

1.23 

1 

0 

49 

% 

44.39 

59.1 

106.3 

.94 

2 

42 

56 

1 

0 

64 

64 

1.5 

0 

0 

75 

% 

0 

24.4 

24.4 

3.6 

0 

0 

75 

% 

0 

30.6 

30.6 

3.2 

0 

0 

75 

% 

0 

31.5 

31.5 

3.1 

0 

0 

75 

% 

0 

39.8 

39.8 

2.5 

0 

0 

50 

% 

10.6 

6 

16,6 

3.3 

0 

23 

27 

Vo. 

4.70 

69.5 

74.7 

1.3 

1 

5 

94 

1 

48.2 

46.9 

98.4 

1 

5 

74 

71 

1% 

57 

2.9 

92.9 

1 

70 

124 

6 

2 

44.8 

53.8 

139.2 

.7 

80 

89 

106 

2% 

15.98 

25.34 

51.19 

1.9 

29 

47 

74 

11/2 

138.9 

22.26 

231.5 

.43 

82 

235 

33 

31/2 

70.1 

7.1 

115.4 

.87 

66 

122 

12 

2 

30.6 

599 

49.23 

2.3 

40 

91 

19 

IVo. 

1.3 

13.4 

18 

5.6 

14 

5 

56 

% 

3.2 

12.8 

19 

6 

12 

12 

51 

% 

20.8 

26.1 

49.5 

2.1 

8 

63 

79 

1% 

4 

24.7 

38. 1 

26 

25 

10 

65 

1 

5.1 

17.2 

28.38 

3.5 

26 

22 

77 

1V+ 

0 

.5 

3.3 

30.2 

14 

0 

2 

i 

6 

2%  Sandwich,   Eibbon   7.4 

1  Sandwioh,  Eice  Biscuit  8.6 

214   Sandwich,  Salad  5.07 

3       Sandwioh,  Yogiirt  Cheese  10.1 

2%  Sandwich,  Yoghurt  and  Jelly..  10 
1%   Sandwich,  Yogurt  and  Olives     7.3 

SAUCES— 

21/4  Bechamel  Sauce 3.02 

2  Brown  Cream  Sauce  4 

2%  Brown  Cream  Protose  Gravy..     7.4 
2%  Brown  Sauce  for  Entries  1 

1  BrowTi  Nut  Gravy 7.9 

21/4   Celery  Sauce  4.2 

1%  Cream  Gluten  Gravy 4.3 

2  Cheese  Sauce  i 3.14 

2  Creole  Sauce -....     2.3 

1       Hollandaise  Sauce  2.64 

1       Mint  Sauce  0 

%  Mushroom  Sauce  2.18 

21/4  Parsley  Sauce 3.7 

2%  Protose  Gravy  6.19 

3  Tomato  Sauce  2.5 

214  Tomato  Gravy  1.09 

11/2  Brown  Sauce  No.  2  1.51 

21/4  Brown  Gravy 1.5 

SAUCES  FOE  DESSEET— 

1%  Almond  Cream 14.1 

3/4  Apple  Tart  2 

11/4   Cocoanut    3.8 

V2  Cream,  Whipped  2.9 

1       Custards 3.89 

%  Golden  Sauce 2.4 

%  Hard  Sauce  17 

114  Lemon  Sauce 0 

%  Meltose  Dressing 1.1 

1  Orange  Fluff  Sauce 2.68 

11/4  Orange  or  Liquid  Sauce  0 

2%  Peach  Sauce  for  Flakes 0 

214  Eed     Easpberry     Sauce     for 

Flakes 0 

2%   Strawberry  Sauce  for  Flakes..     0 

11/4   Strawberry  Sauce -     0 

11/2  Vanilla  Sauce  0 

1%  Brown  Sugar  Sauce  02 

1%  Lemon  Sauce  3.2 

2%   Sanitas    Steak-Tomato    32.3 

2  Savory  Eoast   40.6 

3  Savory    Spaghetti    9.86 

1%   Sanitas  Cutlets  with  Ci'eam....  54.3 

2  Sanitas   Cutlets 38.2 

3  Sanitas  Fi'ieassee  :.     3.2 

41/4   Scotch  Brose,   3.3 

4  Scotch  Bran  Brose  3.2 

3       Slaw,   Hot  2.74 

4:%  Soup,  Bean  9.4 

4%   Soup,  Black  Bean 6.08 

4%   Soup,  Bean  Broth  No.  1 2.8 


224 


TIJE    BATTLE    CREEK    SANITARIUM 


Calories   Poi'   Ounce 


.5>> 


«  is 


d,       ^ 


Calories  Served 


o 


4%  Soup,  Bean  Broth  No.  2 4.3 

4%  Soup,  Kidney  Bean  11.25 

4%  Soup,  Lima  Bean 6.58 

4%  Soup,  Navy  Bean  9.4 

4%  Soup,  Bean  Tapioca  2.17 

4%   Soup,  Bouillon  6.99 

4%  Soup,   Tomato  Bouillon   8.62 

4%  Soup,  Vegetable  Bouillon  7 

4%  Soup,    Brown    54 

4%  Soup,  Cablbage  (raw)   3.4 

4%  Soup,  Celery  and  Tomato  — .  2.7 

4%  Soup,  Corn " Chowder  2.6 

4%  Soup,    Com    Chowder,    Wash- 
ington      2.5 

4%  Soup,  Cream  of  Almond  3.1 

4%  Soup,  Cream  of  Asparagus....  3.24 

4%  Soup,  Cream  of  Barley  2.11 

4%  Soup,  Cream  of  Bean  No.  1..  6  OS 

4%  Soup,  Cream  of  Bean  No.  2..  6.7 
4%  Soup,     Cream     of     Browned 

Onion    3.11 

4%  Soup,  Cream  of  Cabbage  2.26 

4%  Soup,  Cream  of  Carrots  3.29 

4%  Soup,  Cream  of  Celery  2.86 

4%  Soup,  Cream  of  Chestnut  4.4 

4%  Soup,  Cream  of  Corn  3.5 

4%  Soup,  Cream  of  Dasheen  4.9 

4%  Soup,   Cream   of  Lentil   10.1 

4%  Soupi,  Cream  of  Lettuce  5.37 

4%  Soup,  Cream  of  Lima  Bean..  6.76 

4%  Soup,  Cream  of  Okra  1.5 

4-14  Soup,  Cream  of  Oatmeal  3.39 

4%   Soup,  Cream  of  Peas 7.37 

4%  Soup,,  Cream  of  Peas  No.  1....  5.9 

4%  Soup,   Cream  of  Potato  2.7 

4%  Soup,  Cream  of  Rice  2.9 

4%  Soup,  Cream  of  Rice  and  Al- 
mond   5.8 

4%  Soup,  Cream  of  Scotch  Pea..  6.14 

4%  Soup,  Cream  of  Spinach 3.55 

4%  Soup,  Cream  of  Split  Pea  ....  6.3 

4%  Soup,  Cream  of  Squash  2.9 

4%  Soup,  Cream  of  Sweet  Potato  4.68 

4%  Soup,  Cream  of  Tomato  2.8 

4%  Soup,  Cream  of  Vegetable 

Oyster    2.4 

4%  Soup,  Creole  7 

4%  Soiip,   Dasheen    Tomato   69 

4%   Soup,    Egg   with   Dumplings..  2.58 

4%  Soup,,  Fruit  No.   1   15 

4%   Soup,  Fruit  No.  2  39 

4%  Soup,   Fniit    (raw)    26 

4%  Soup,  Grolden  Bouillon  1.29 

4%  Soup,    Italian   1.3 

4%  Soup,  Lentil   5.45 

4%  Soup,  Lentil  No.   1  5.6 

4%  Soup,  Mock  Chicken  Broth....  1 

4%  Soup,   Noodle   2.2 

4%  Soup,  Nut  and  Rice  1.27 

4%  Soup,  Nut  French  2.2 


3.16 

9.48 

1.26 

4 
.4 
28.11 

7.96 

4.3 

.2 

ll'7 

3.8 

7.8 

11.2 
23.17 
18.33 
14.76  17.16 
15.2     14.1 
12.6     15.2 


11.58 
21.38 
24.16 
24.7 

8.9 

5.1 

4.77 

7 

5.24 

5.8 

6.3 
12.2 

10.8 
3.87 
4.57 


21.34 
10.85 
16.1 
19.02 
18.3 
18.5 
15.57 
12.6 
28.85 
14.4 
5.6 
13.26 
12.95 
18 
19.2 
17 

20.8 

14.6 

22 

14.6 

10.3 


8.35 
5.76 

8.22 

4.7 
15.4 
10 
30.9 
22.2 

9.68 
21.69 
10.2 

9.2 
18.49 
13.2 

9 

8.8 

8.6 
14.1 

6.45 
14.5 

21.4 


19.1 
42.1 
32.1 
38.1 
11.5 
40.2 
16.37 
18.3 
6 
21.2 
12.8 
22.6 

24.5 

30.15 

26.14 

24.03 

35.38 

33.1 

32.8 

18.87 

27.6 

26.58 

38.1 

32.12 

50.56 

45 

43.9 

42.82 

17.4 

25.9 

38.81 

37.1 

30.9 

28.7 

34.5 
34.84 
32 
35.4 
34.6 


5.2  22 
2.37  53 
3.1 


2.7 
8.7 


31 

25 
10 

2.5  34 
6.1  17 
5.49  29 

18  2 
4.75  17 
7.8  10 
4.8  11 

4.6  12 
3.31  16 
3.82  16 
4.1  12 
2.85  29 
3  26 

3  15 

5.29  13 

3.62  15 

3.7  13 


2.6 

3.1 

1.9 

9.5 

2 

2.3 

6.3 

3.9 

2.8 

2.7 

3.2 

3.48 


20 
16 
25 
45 
24 
32 
5 
17 
32 
28 
13 
13 


2.8 
2.8 


21 
32 
3  16 
2.83  31 
2.6  15 
13.34  17  53  35.56  2.8  23 
20    5.96  28.76  3.4  10 

21 
4.3 
14.18 
34.37 
.01526.8 
.17  29.33 
.28  21.35 
1.66  4.82 
3.9   3.5 
3.37  13.27 


4.6 
7 

1.72 
4.19 


.46 
14.5 
6.05 
3.83 
4.3 


11.7 
6.4 

8.51 
2.61 
4.1 


28 
18.3 
16.59 
41.14 
27.05 
29.9 
21.89 
7.7 
8.78 
22.11 
17.3 
21.9 
16.8 
7.72 
10.76 


3.6 
5.49 
6.25 
2.4 
3.7 
3 

4.5 
12.87 
11.4 
14.54 
5.7 
4.75 
6.33 
17.5 
9.3 


11 

29 
3 

21 
1 
2 
1 
4 
7 

24 

22 
3 

10 
4 

10 


16 
45 

5 
10 

1 

140 

36 

]8 

1 
56 
14 
35 

58 
115 
88 
76 
76 
56 

98 
55 
73 
90 
84 
87 
75 
53 
133 
68 
24 
63 
57 
84 
93 
74 

93 

72 
104 
72 
52 
65 
90 

94 

18 

65 

152 

0 

1 

1 

4 

23 

16 

2 

67 

25 

13 

20 


62 
102 
114 
65 
39 
26 
22 
28 
22 
27 
26 
54 

55 
19 
21 
37 
70 


37 
32 
37 
22 
71 
47 
100 
102 
43 
100 
46 
45 
86 
63 
44 
38 

36 
71 
30 

72 

108 

87 

25 

20 

28 

7 

77 

124 

147 

98 

17 

20 

60 

51 

30 

40 

8 

20 


1 

2 

V/j 

1 

2 
% 
% 

1/4 


1 

iVi 

1V2 
11/4 
1V4 
1% 
11/0 

11/2 

1 

11/4 
11/4 
1% 
11/2 
21/2 

2 
2 
2 

% 
11/4 
1% 

1% 
11/. 
11/4 

11/2 
1% 
11/2 
1% 
1% 
1% 

11/4 
% 
% 
21/2 
1% 
11/2 
1 

1/4 


% 

[ 

% 
1/4 
¥2 


225 


THE    BATTLE    CREEK    SANITARIUM 


Calories   Per   Ounce 


fl-2o 


o° 


Pm 


^ 


^4     •« 
CSrrt 

o 


Calories   Served 


o 


5 

4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
4% 
3 
4 
3 
3 
3 
4 

31/2 
4 
3 

21/0 
31/2 
1/2 
4 
5 

31/2 
3 

3 

1 

3 

31/2 

5 

5 

5 

31/2 

5 

5 

5 

1/2 
5 

IV2 

5 

4 


Soup,  Oatmeal  

Soup,  Okra 

Soup,  Peas  Consomme   

Soup,   Green  Peas  , 

Soup,  Peas  and  Potato  

Soup,   Potato    Savory   

Soup,  Protose  Broth  

Soup,   Split  Peas 

Soup,  Split  Peas  Purees 

Soup,    Potato    *. 

Soup,  Potato  ChoiwdeT 

Soup,  Potato  Chowder   (new) 

Soup,    Saniterrapin    

Soup,   Savora  Broth 

Soup,   Savory  Dasheen  

Soup,  Savora  Eioe  

Soup,  Spinach    (raw)    

Soup,  Tomato  Bisque  

Soup,  Tomato 

Soup,   Clear  Tomato   

Soup,  T'omato  and  Macaroni.. 

Soui>,    Tomato    Rice    

Soup,  Tomato  Vermicelli  

Soup,    Vegetable 

Soup,  Vegetable  Bouillon   .... 
Soup,    Vegetable    Consumme.. 

Soup,  Vegetable  Oyster 

Soup,  Vegetable  Oyster,  Rev. 

Spaghetti    Cutlets    

Spaghitti   Milanaise    

Spaghitti   Earebit   

Spaghetti  and  Tomato  

Spinach    

Spina/eh  a  la  Bechamel 

Spinach,   Creamed    

Spinach  on  Toast 

Spinach  Souffle 

Squash,   Baked 

Squash,   Steamed   or  Canned.. 

Sticks,  Cream  

Strawberries,    Fresh    

Strawberry    Juice 

Strawberry   Sauoe   

String  Beans  with   Cream 

Succotash 

Sugar     (Granulated)     

S\^ass   Chard 

Sweet  Potatoes    (Cooked)    .... 

Tangerines    

Toast,    Apple    

Toast,   Apricot   

Toast,  Asparagus  Cream   

Toast,   Banana   

Toast,   Blackberry    

Toast,   Blueberry   

Toast,  Breakfast 

Toast,  Cherry 

Toast,   Cinnamon   

Toast,   Cream   

Toast,  Cream  Celery 


3.9 

.8 
7.1 
4.8 
5.81 
2 

3.2 
7.18 
8.62 

.88 
2.7 
2.7 
2.3 
0 

.14 

.11 
3.34 
3.1 
2 

3.1 

1.15 

1 

5.4 
.96 

5.7 

2.1 
.38 
.36 
13.82 

6.7 

7.6 

5 

3.3 

3.4 

3.5 

5.3 

6.4 

1.6 

1 
10 

1.2 

0 
.9 

2.34 

9.25 

0 

2.5 

3.5 
.9 

1.4 

2.2 

4 

3.2 

1.86 

1.95 
11.4 

2.2 
13.9 

4.15 

5.47 


40.8 
.44 
5.2 

14.5 

14.25 

5.2 

.9 

1.85 

15.2 
2.41 

17 

15.2 
9.91 
2.5 
4.57 
2.46 

14.38 

10.5 
2.3 


7.8 
6.9 
5.71 


14.7 
2.8 
8.6 
7.8 

17.13 
7.5 
2.9 

18.7 

24.7 
7.2 

10.4 

11.5 
2.96 
1.5 
.63 
.9 
5.29 
2.4 
6.4 
8.9 
2.97 
4.8 
4 
6.9 


.78  21.1 


.5 
10.7 

6-2 
28.49 
44.6 
18.6 

3.86 

1 
17.6 
13.7 
28 
19.3 

2.2 

1.3 
.9 

1.6 

0 

1 
20.35 


7.7 
1.41 
1.41 
32.35 
25.3 
8.8 
17.16 
4.93 
6.58 
5.9 
18.7 
6.7 
16 
12.3 
89.2 
8.6 
24.5 
22.7 
3.15 
15.42  32.65 

0   116.6 
10.9   3 

5.6  49.1 
.5  13.5 

3.48  27.2 

2.7  27.1 


22 
15.9 
5.7 


65.9 
22.4 
34.8 


9.23  23.9 
27.5  86.2 


4.5 
29.3 
29.9 
32.38 


35.8 
31.2 
13.6 
21 


59.4 

3.6 
20.9 
27.2 
37.19 
14.7 

7 
27.1 
48.5 
10.5 
30.1 
29.5 
15.2 

4 

5.34 

3.47 
23.1 
16 
10.7 
19 

4.8 
13.6 
16.3 
13.5 
26.8 
11,3 
11.86 

7.79 
74.6 
76.5 
35 
26.02 

9.3 
27.7 
22.39 
52.1 
32.4 
19.8 
14.6 
100.1 
11.4 
24.5 
24.6 
25.84 
57.34 
116.6 
16.4 
58.2 
14.9 
32.08 
32 
100 
41.5 
42.36 
35.08 
125.1 
41.8 
74.4 
47.65 
58.9 


1.66 
17.5 

4.75 

3.6 

2.8 

6.8 
14.2 

3.6 

2.1 

2.3 

3.3 

3.5 

6.5 

2.5 
18 
18 

4.34 

6.2 

2.3 

5.2 
20.8 

6 

6 

7.4 


20 

6 

34 

21 

27 

11 

11 

34 

38 

4 

13 

15 

11 

1 

1 

1 

15 

14 

9 

17 

5 

6 

24 

1 


3.72  17 
.9  12 


8.7 
14 

1.3 

1.7 
.33 

3.9 
10.7 

3.4 

4.69 

i.9 

3 

5 

6.8 

1 

8.7 

4.1 

4.07 

3.48 


1 

1 

41 

25 

22 

15 

9 

20 

10 

20 

20 

4 

3 

5 

5 

0 

3 

7 


1.74  28 


.9 
6.9 
1.7 
6.9 
3.12 
3.1 
1 

2.4 
2.35 
2.8 

.8 
2.3 
1.3 
2.1 
1.6 


0 
9 

12 

5 

4 

10 

13 

13 

7 

10 

4 

10 

16 

18 

23 


205 

5 

25 

68 

67 

26 

3 

8 

71 

11 

86 

77 

50 

15 

22 

17 

62 

50 

11 

36 

3 

43 

32 

23 

3 

2 

44 

20 

86 

175 

53 

11 

3 

88 

47 

110 

59 

6 

5 

1 

7 

0 

3 

60 

48 

0 

1 

19 

2 

14 

12 

46 

77 

26 

46 

12 

20 

40 

143 

137 


75 
14 
41 
36 
81 
38 
11 
83 

116 

35 

51 

58 

14 

9 

3 

7 

23 

11 

30 

47 

17 

26 

19 

26 

80 

36 

5 

4 

98 

100 
25 
49 
13 
17 
18 
70 
21 
40 
42 
44 
38 

125 
69 
8 
99 
25 
15 

169 
68 

132 

128 
66 

110 

167 

119 
34 

170 
44 
64 
90 


3 

1 

1% 

1% 
% 
1/4 

1% 

21/4 
1/2 

1% 

11/2 
% 
1/4 
1/4 
1/4 

1 
% 
1/2 

1 
1/4 
% 
% 
1/2 

1 

1/2 
1/2 
1/4 

21/4 

3 

1 
% 

11/4 
% 

2 
1 

1/2 
¥2 
1/2 

11/4 
% 
% 

1% 
1/4 
1/4 

2 

% 
1% 
11/2 
11/4 
2 
2 
1% 

1/2 
2 
1 

21/4 
21/2 


226 


THE  batti;e  cheek  sanitarium 


.2  !>■- 


a. 5 


S   t<   O) 


Ciilorics   Per   Ounc( 


j.^  Calories  Served 

K  *2    -s  o  i 


414  Toast,  Cream   Okra  2.1 

2V2  Toast,   Egg   on  14.1 

41/^  Toast,  French  Apple  4.65 

5  Toast,    Gra/pe   1.14 

5  Toast,    Gravy   4.47 

4%  Toast,  Onions  on  4 

5  Toast,  Peaeh     1.5 

5  Toast,    Prune    1.86 

5  Toast,  Red  Raspberry  2.2 

11/'  Toast,  Russian  14.5 

5  Toast,  Snow  Flake  5.09 

5  Toast,    Strawberry    1.95 

5  Toast,   Tomaito   2.26 

3  Toast,  Baked  Tomatoes  on....     4.7 

4  Toast,  Tomato  Cream  5.16 

6  Toast,  Creamed  Turnips  on....'   3.4 

5  Toast,  Yogurt  Cbeese  3.96 

3^2  Tomatoes,   Breaded   1.3 

21/^  Tomatoes,   Stewed  or  Canned     1.4 

5  "  Tomatoes,   Stuffed  1.63 

4  Tomatoes,   Sliced   1 

4  Txirkish  Pilaf  3.9 

3  Turnips,   Creamed   - 2.18 

3  Turnips  in   Drawn   Butter 

Sauce    6 

4  Turnips,   Mashed   6 

11/,  VaniUa  Egg-Nog  ..- 20.6 

2%  Vegetf^ble  Hash  2.5 

2%  Vegetable  Oysters,   Creamed..     2.14 

3  Vegetable  Oysters,  Escalloped     2.5 

1%  Vegetable  Oyster  Fritter 3.6 

2i/>  Vegetarian   Hajn 11.5 

41/^  Vitos    - - 2.9 

2%  Walnut  Roast - 9.5 

11/4  Watercress     1.4 

8  Watermelon    5 

31/.  Wlieat   Brose    1.7 

5%  Wheat,  Cracked - 3.3 

%  Wheat  Flakes,  Toasted  11 

4  Wheat  Grits  (Cooked)   2.1 

5%  Wheat,   Hulled   3.3 

7  Whey    1-2 

1/2  Whipped  Cream  2.9 

1  Whole-wheat  Wafers  or 

Crackers    11.4 

6  Yogurt  Buttermilk  - 4 

1  Zwieback  11.4 


28.4 

18.2 
9.73 
2.63 

23.57 
6.4 
2.45 
3 
2.7 

64.9 

23.17 
3.65 
3.2 
9.6 

28.8 

10.7 

28 
4.5 
.5 
8.94 
1.1 
1.42 
4.6 

15.3 

2.8 

.8 

7.1 

12.76 

13.7 

22.5 

30^2 

1.3 

40 


1 
3.9 

1 
1 
.8 
49.3 

26 

.8 
26.4 


6.2 

25.3 

27.4 

32.8 

16.72 

21.2 

24.3 

32.38 

28.4 

9.9 

14.64 

29.05 

16.2 

20.2 

21.4 

16.4 

13.9 

7.9 

4.7 

8.72 

4.6 

26.8 

10.9 

3.49 
2.7 

38.8 
17.4 

6.17 

8.3 
18.7 

6 
23.7 
22.5 

3.4 

7.8 
12.6 
22 
88.9 
15.3 
22 

5.8 
10.14 


36.8 

57.7 

41.78 

36.57 

44.5 

31.6 

28.3 

37.24 

33.4 

89.4 

42.9 

34.65 

21.66 

34.6 

55.4 

30.7 

45.9 

13.7 

6.6 
19.3 

6.7 
32.13 
17.7 

19.39 
6.1 

60.5 

27 

21 

24.5 

44.8 

47.7 

27.9 

72 
5.6 
8.8 

15 

26.3 
103.8 

18.4 

26.3 
7.8 

62.3 


84.5  121.9 

6    10.8 

85.8  123.6 


2.7  14 

1.7  36 

2.3  16 

2.7  5 

2.25  25 

3  15 

3.5  8 


2.6 

3 

1.1 


8 
12 

18 


2.34  21 

2.8  10 


4.6 

2.8 

1.8 

3.2 

2 

7.3 
15.1 

5 
16 

3 

5.6 

5.15 
16.4 
1.6 
3.7 
4.75 
4 

2.3 
2.2 
3.5 
1.4 
17.8 
11.4 
6.5 
3.8 

.96 

5.4 

3.8 

12.8 

1.6 


9 
18 
23 
20 
19 


4 

15 

6 


48 
39 
12 

116 
25 
13 
12 
15 
93 

111) 
19 
14 
35 

130 
61 

138 

17 

2 

47 

4 

5 

13 

40 

12 

2 

20 

30 

42 

25 

79 

4 

112 

1 

4 

2 

6 

3 

4 

6 


79 

66 

120 

158 

84 

85 

129 

155 

148 

14 

69 

146 

77 

72 

97 

94 

68 

28 

18 

45 

17 

105 

31 

9 
11 
64 
49 
15 
25 
22 
16 
86 
62 
7 
67 
42 

126 
64 
62 

126 


5.6  40 

20    4 


.81  12 
9.2  28 
.8  11.4 


11/, 
11/2 
1% 
1% 
21/4 
11/4 
11/2 
1% 
1% 

ly* 
2 

1% 
1 

1% 
21/0 
1% 
21/4 
1/2 
y4 
1 

y4 

ly* 

y2 

V2 

1 

% 
V2 
% 
V2 

iy4 

1 

2 
1 

T(T 
% 
V2 

lya 
% 
% 

11/0 

6     1/2 

y4 


27 
5 
26.4 


86  1% 
42  % 
85.8  114 


FLESH  FOODS 


31/,  Beef    Juice    5.42  1.71  0  7.13  14  19  6  0 

21/^  Beef,  Roasted  (Fat)   18.14  136.85  0  155.26  .65  48  352  0 

214  Beef,  Round   (Boiled,  Lean)..  40.9  4.54  0  45.6  2.2  90  10  0 

6  Bouillon  2.3  .3  3  3  33  23  1  1 

314  Chicken    (Broilers)    24.6  6.56  0  31.16  3.2  79  21  0 

3%  Clams                           7.5  1.08  0  8.58  11.6  28  4  18 

5  Cod  Fish               19.3  1.02  0  20.32  4.9  95  5  0 

2%  Goose    18.1  95.4  0  113.5  .88  48  252  0 

3  Halibut    (Steak)    21.78  13.9  0  35.68  2.8  61  39  0 


227 


THE    BATTLE    CREEK    SANITARIUM 


lories   P 

er   Ounce 

r-— ■ 

Calories 

Served 

to 

o  -2 

1^ 

"3 
o 

«-S6 
500 

0 

fi 

0  -S 

1^ 

St3 
Cm 

79.7 

0 

105 

.96 

48 

152 

0 

2 

33.3 

0 

55.5 

1.8 

80 

120 

0 

2 

13.9 

0 

35.68 

2.8 

61 

39 

0 

1 

4.8 

0 

23.82 

4.1 

39 

10 

1 

V2 

54.1 

0 

83.2 

1.2 

70 

30 

0 

1 

3.23 

0 

10.43 

6.8 

24 

12 

14 

V2 

177.3 

0 

188.6 

.53 

12 

188 

0 

2 

65.4 

0 

90.3 

1.1 

56 

144 

0 

2 

84.5 

0 

103 

.97 

54 

246 

0 

3 

46.6 

0 

66.6 

1.5 

45 

105 

0 

IVo 

25.71 

0 

47.61 

2.1 

46 

54 

0 

1 

55.5 

0 

77.7 

3.6 

40 

10 

0 

Vo 

59.1 

0 

83.2 

1.2 

29 

71 

0 

1 

11.2 

0 

41.6 

2.4 

73 

27 

0 

1 

2  Lamb  ChofS  (Boiled)  25.3 

31/^  Lamb    (Leg,  Eoast)    22.2 

3  Liver    (Veal)    - 21.7S 

2  Lobsters  - 19 

2%  Mutton    (Leg,  Boiled)    29.1 

31/2  Oysters  - 7.2 

1       Pork  (Bacon,  Smoked  Medium 

Fat)    11.3 

21/4  Pork  (Ham,  Boiled)   --  25.4 

3  Pork   (Loin,   Chops)    18.5 

214  Salmon    (California)    - 20.4 

214  Shad     -  21.9 

1%  Trout   (Brook)   - - 22.2 

11^  Turkey     24.1 

21/2  Veal  (Leg,  Boiled)   30.4 


NUMBER  OF  FOOD    UNITS   OR   CALORIES   PER    OUNCE    OF   VARIOUS 
UNCOOKED  FOODSTUFFS 


None  of  these  are  served  in  the  uncooked  state.    The  value  is  given  only 

for  the  purjDose  of  comparison  of  actual  food  values. 

Proteins 

Almond  Meal   -  26.0 

Ai'tichokes    - 3.0 

Asparagus   - 2.1 

Barley,   Pearled 9.9 

Beans    (dried)    - — ..  26.3 

Beans,  Butter   (green) 11.0 

Beans,  Lima   (dried)    — - - 21.1 

Beans,    Soja    38.4 

Beets    - 1.9 

Beans,  String 2.7 

Buckwheat     - - -  7.5 

Cabbage  - — - - 1-9 

Carrots  , - 1-3 

Cauliflower    2.1 

Cocoa   - :: -- 25.2 

Cocoa,   Sanitas   - - - 25.6 

Corn,  Green - - 3.6 

Corn,  Parched    (Gofio) 13.4 

Cornmeal   --- 1 0.7 

Cornstarch - 

Cranberries    - .6 

Egg    Plant - 1.4 

Farina    - --  13.0 

Flour,  Corn  .— - 8.3 

Flour,   Graham  - 15.5 

Flour,  Eye  - 7.9 

Flour,  Sanitas  Self-Eaising  Gluten  20.0 

Flour,  Sanitas  Self -Raising  Gluten,  40  per  cent  46.4 

Flour,  Wheat   (Entire  Wheat)   16.1 

Flour,  Wheat   (Fine  White) 9.2 

Flour,  Wheat  (Gluten) 16.6 

Flour,  Wheat,   (Pastry) 15.5 

Flour,  Wheat    (Patent) ...-  12.6 

Gooseberries -  .5 


Fats 

Carbohydrates 

Total 

152.8 

21.4 

200.2 

.5 

19.5 

23.0 

.5 

3.9 

6.5 

2.9 

90.8 

103.6 

4.8 

69.5 

100.6 

1.6 

34.0 

46.6 

4.0 

76.9 

102.0 

48.3 

33.5 

120.2 

.3 

11.3 

13.5 

.8 

8.6 

12.1 

3.2 

90.0 

100.7 

.8 

6.5 

9.2 

1.1 

10.9 

13.3 

1.3 

5.5 

8.9 

77.1 

44.0 

146.3 

76.7 

44.5 

146.8 

2.9 

23.0 

29.5 

22.4 

84.4 

120.2 

5.1 

87.9 

103.7 

105.0 

105.0 

1.6 

11.5 

13.7 

.8 

6.0 

8.2 

3.7 

89.0 

105.7 

3.5 

91.5 

103.3 

5.9 

83.3 

104.7 

2.4 

91.8 

102.1 

4.0 

83.4 

107.4 

2.7 

51.0 

100.3 

5.1 

83.8 

105.0 

3.7 

89.1 

102.0 

4.8 

83.0 

104.4 

5.9 

83.3 

104.7 

2.9 

87.7 

103.2 

10.4 

10.9 

228 


TllK    BATTLE    CREEK    SANITARIUM 


Proteins 

Gluten  Meal,   (20  per  cent)   18.4 

Hominy    9.7 

Koihl-rabi   2.3 

Lemons  1.2 

Lemon.  Juice  0 

Lentils   30.0 

Macaroni    3.5 

Mushrooms    4.1 

Nut   Meal   65.3 

Oatmeal  18.8 

Oats,  EoUod   19.5 

Onions 1.9 

Parsnips    1.9 

Peanuts    22.8 

Peas  (dried)   28.7 

Peas,   Oow    (dried)    25.0 

Peas,  Green 8.2 

Potato  Meal  11.3 

Potatoes  -. 2.6 

Prunes    2.5 

Pumpkin    1.2 

Eadishes    1.5 

Eice  9.0 

Spinach 2.5 

Squash    1.6 

Sweet   Potatoes   2.1 

Turnips 1.5 

Vegetable  Oysters  or  Salsify  1.0 

Wheat,   Cracked   13.0 

Wheat  Grits 12.3 


Fats 

Carbohydrates 

Total 

1.7 

83.6 

103.7 

l.G 

92.2 

103.5 

.3 

6.4 

9.0 

1.9 

10.1 

13.2 

0 

11.4 

11.4 

2.7 

69.1 

101.8 

4.0 

18.4 

25.9 

1.1 

7.9 

13.1 

90.7 

12.8 

108.8 

19.2 

78.8 

116.8 

19.5 

77.2 

116.2 

.8 

11.6 

14.3 

1.3 

1.5.8 

19.0 

77.6 

21.6 

122.0 

2.7 

72.3 

100.7 

3.7 

70.9 

99.6 

1.3 

19.7 

29.2 

1.0 

97.0 

109.3 

.3 

2L5 

24.4 

0 

85.8 

88. 

.3 

6.1 

7.6 

.3 

6.8 

8.6 

.8 

92.0 

101.8 

.8 

3.7 

7.0 

1.3 

10.5 

13.4 

1.9 

32.0 

36.0 

.5 

9.5 

11.5 

5.3 

4.1 

10.4 

4.5 

88.1 

105.6 

5.3 

88.7 

106.3 

229 


DATE  DUE 

^     i()Q0 

mi 

7       X3^ 

\ 

' 

1 

Pfinled 
in  USA 

.■'«>,l»    , 


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